Federal Reports

Of the $18.9 million of Child Care and Development Fund targeted fund expenditures that we reviewed, the Commonwealth of Puerto Rico, Department of the Family (State agency), complied with Federal requirements for the use of $6.4 million. However, the State agency did not comply with Federal requirements for the use of the remaining $12.5 million. Specifically, the State agency used $10.9 million for nontargeted fund activities and $1.6 million in targeted funds for contractor activities not specified as "targeted."

The Utah Department of Technology Services' management had not established an effective enterprise security control structure to ensure that adequate information system general controls were implemented in conformance with Federal requirements over the systems used to support the Utah Department of Health's Medicaid eligibility determination and claims processing. These inadequate security management practices put Medicaid systems and data at risk.

Medicaid is the primary source of dental coverage for children in low-income families and provides access to dental care for approximately 37 million children. However, access to dental care for children with Medicaid has been a longstanding concern. When children lack dental care, untreated decay and infection in their mouths can result in preventable emergency room visits or more complicated and expensive dental and medical interventions later in life. Medicaid provides dental services to children through the Early and Periodic Screening, Diagnostic, and Treatment program. Under this program, States are required to cover all medically necessary dental services and these services must be provided at the intervals specified in States' pediatric dental periodicity schedules.

This report contains classified information that is exempt from disclosure under the Freedom of Information Act. To obtain further information, please contact the OIG Office of Counsel at OIGCounsel@oig.treas.gov, (202) 927-0650, or by mail at Office of Treasury Inspector General, 1500 Pennsylvania Avenue, Washington DC 20220.

Long-term-care employees provide essential care to patients in settings such as nursing facilities, home health agencies, and hospices. Ensuring that these employees have undergone a minimum level of screening helps protect the safety of beneficiaries in these settings. The Patient Protection and Affordable Care Act (ACA) provides grants to States to implement background check programs for prospective long-term-care employees. The ACA also requires OIG to conduct an evaluation of this grant program-known as the National Background Check Program-after its completion. This interim report describes the overall implementation status and States' results from the first 4 years of the program, and provides CMS with information that may assist its ongoing administration of this program. OIG also plans to issue a final evaluation of the grant program after its completion.

Not all of the Washington Health Benefit Exchange’s (Washington marketplace) internal controls were effective in ensuring that individuals were enrolled in qualified health plans (QHPs) according to Federal requirements.

This report contains information about recommendations from the OIG’s audits, evaluations, and reviews that the OIG had not closed as of the specified date because it had not determined that the Department of Justice had fully implemented them. The information omits recommendations that the Department of Justice determined to be classified or sensitive, and therefore unsuitable for public release. The status of each recommendation was accurate as of the specified date and is subject to change. Specifically, a recommendation identified as not closed as of the specified date may subsequently have been closed.

The NARA Office of Inspector General engaged, CliftonLarsonAllen LLP, to conduct an audit in support of the FISMA requirement for an annual evaluation of NARA’s information security program. The objective of this performance audit was to determine whether NARA implemented selected security and privacy controls for selected information systems in support of FISMA and related information security policies, procedures, standards and guidelines.

The Government Charge Card Abuse Prevention Act of 2012 requires inspectors general to conduct periodic risk assessments of their agency’s purchase card program to identify and analyze the risks of illegal, improper, and erroneous purchases and payments. Inspectors General must then use the results of those risk assessments to determine the scope, frequency, and number of periodic audits of purchase card transactions to perform in the future. Our review determined that the purchase card program does not pose a high risk to the Department and an audit of the program was not necessary.

The Puerto Rico Department of the Family (State agency) did not ensure that providers that received funds from the Child Care and Development Fund (CCDF) complied with Administration for Integral Child Care and Development (lead agency) requirements related to the health and safety of children. We found that all 20 providers that we reviewed did not always comply with lead agency requirements to ensure the health and safety of children. Specifically, we found potentially hazardous conditions at 19 of the 20 providers, and 11 of the providers did not comply with requirements to obtain background checks on household members and employees.

The State agency claimed costs under Federal fiscal years 2010 through 2013 Centers for Disease Control and Prevention (CDC), Prevention and Public Health Fund (PPHF), awards that were not always in accordance with Federal requirements. Of the 135 sample items with transactions totaling $3.43 million in our statistical sample, 126 totaling $3.4 million were allowable, but 9 totaling $27,000 were not. In addition, of the 156 subgrantee transactions totaling $847,000 in our judgmental sample, 152 totaling $824,000 were allowable, but 4 totaling $23,000 were not. The State agency claimed unallowable costs under CDC PPHF awards because it did not have adequate controls to ensure that all costs charged to the awards were allowable.

Although the Montana Department of Public Health and Human Services (State agency) generally complied with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs, it claimed unallowable Federal reimbursement for some of these drugs. The State agency did not invoice manufacturers for rebates associated with $24,000 ($16,000 Federal share) in physician-administered drugs. Of this amount, $19,000 ($13,000 Federal share) was for single-source drugs, and $5,000 ($3,000 Federal share) was for top-20 multiple-source drugs. Because the State agency's internal controls did not always ensure that it invoiced manufacturers to secure rebates, the State agency improperly claimed Federal reimbursement for these single-source drugs and top-20 multiple-source drugs

This Newsletter provides a bimonthly summary of selected investigative accomplishments.

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

Danbury Hospital (the Hospital), located in Danbury, Connecticut, did not always comply with Medicare requirements for reporting wage data in its fiscal year (FY) 2010 Medicare cost report. Specifically, the Hospital reported overstated wage data totaling $4.9 million and 10,000 hours, which affected the numerator and denominator of its wage rate calculation. These errors occurred because the Hospital did not sufficiently review and reconcile the data to ensure that it was accurate, supportable, and in compliance with Medicare regulations. Because of the errors, we estimated that in FY 2014 Medicare overpaid the Hospital approximately $249,000 and overpaid five other hospitals in the same core-based statistical area a total of approximately $741,000.

Although the North Dakota Department of Human Services (State agency) generally complied with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs, it claimed unallowable Federal reimbursement for some of these drugs. The State agency did not invoice manufacturers for rebates associated with $138,000 ($79,000 Federal share) in physician-administered drugs. Of this amount, $137,000 ($78,000 Federal share) was for single-source drugs, and $1,000 ($700 Federal share) was for top-20 multiple-source drugs. Because the State agency's internal controls did not always ensure that it invoiced manufacturers to secure rebates, the State agency improperly claimed Federal reimbursement for these single-source drugs and top-20 multiple-source drugs.

We could not determine whether West Virginia's Severance and Business Privilege Tax (Severance Tax) is a permissible health-care-related tax. The Severance Tax does not place at least 85 percent of the tax burden on behavioral health services. We could not determine if the Severance Tax treats behavioral health services differently than the other items it taxes because the tax rates are not consistent and the proceeds from the tax on behavioral health services are placed in a fund different from the proceeds from the other items taxed. Citing privacy restrictions in its tax laws, West Virginia would not provide all the documents we needed to complete our analysis. We did not subpoena those records. Without this information, we could not identify the taxpayers or validate the services being taxed. As a result, we could not determine if the Severance Tax is a health-care-related tax and, if it is, whether it is a permissible health-care-related tax.

This report provides the results of our review of the Indian Health Service (IHS) detailed accounting submission, which includes the Table of Drug Control Obligations, related disclosures, and management's assertions for the fiscal year ended September 30, 2015. We also reviewed the Performance Summary Report, which includes management's assertions and related performance information for the fiscal year ended September 30, 2015.

This report provides the results of our review of the National Institutes of Health (NIH) detailed accounting submissions, which include the tables of Fiscal Year 2015 Actual Obligations, related disclosures, and management's assertions for the fiscal year ended September 30, 2015. We also reviewed the Performance Summary Report, which includes management's assertions and related performance information for the fiscal year ended September 30, 2015.

This report provides the results of our review of the attached Substance Abuse and Mental Health Services Administration (SAMHSA) detailed accounting submission, which includes the Table of Prior Year Drug Control Obligations, related disclosures, and management's assertions for the fiscal year ended September 30, 2015. We also reviewed the Performance Summary Report, which includes management's assertions and related performance information for the fiscal year ended September 30, 2015.

The OIG performed this audit to evaluate the effectiveness of TVA's Information Technology Infrastructure Delivery (ID) group in meeting TVA's mission and values. In summary, we found that ID's operational maturity is well defined. However, there are opportunities for ID to improve its disaster recovery program and improve communications within one of ID's operational groups. TVA management agreed with our findings and recommendations.

A hotline complainant alleged that VISTA and AmeriCorps members serving at a West Virginia grantee site displaced staff employees.

Transmittal of the Management Letter for the Fiscal Year 2015 Financial Statement Audit

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

The California Department of Health Care Services (State agency) did not always comply with Federal Medicaid requirements for billing manufacturers for rebates for physician-administered drugs during three selected quarters between 2008 and 2010. Of $178.6 million in claims that were billed for rebates, we reviewed $61.4 million associated with 26 National Drug Codes (NDCs) and 21 manufacturers to verify that the claims were properly billed for rebates. The entire amount was properly billed for rebates. However, the State agency did not bill for rebates for claims for physician-administered drugs totaling $58.9 million.

The objectives of the audit were to determine whether (1) costs incurred under the award were allowable, allocable, and reasonable; (2) the method chosen for obtaining construction services was effective and efficient; and (3) the power system is working and delivered as intended.

This is our report of our audit of the National Oceanic and Atmospheric Administration’s (NOAA’s) processes for awarding and monitoring Hurricane Sandy Disaster Relief funds. Our audit objectives were to determine whether (1) NOAA followed federal and Departmental guidelines when awarding grants and contracts and making purchase card transactions for equipment damaged by Hurricane Sandy and (2) adequate controls were implemented to ensure Hurricane Sandy Relief funds were effectively monitored.