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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Agreed-Upon Procedures of Philippine Business for Social Progress, Inc.'s Innovations and Multi-Sectoral Partnerships to Achieve Control of Tuberculosis Project that Specifically Covers the Mindanao-Related Transactions and Activities, Award AID-492-A-12-
Audit of the Government of Ghana resources managed by Millennium Development Authority under the Grant and the Millennium Challenge Compact between the Republic of Ghana and the United States for the period April 1, 2020 to March 31, 2021
This report summarizes work we initiated and completed during this semiannual period on a number of critical Departmental activities. Over the past 6 months, our office issued 13 products related to our audit, evaluation, and inspection work. These products addressed programs and personnel associated with the Bureau of Industry and Security, United States Census Bureau, First Responder Network Authority, National Institute of Standards and Technology, National Oceanic and Atmospheric Administration (NOAA), United States Patent and Trademark Office (USPTO), and the Department itself. This report also describes our investigative activities addressing programs and personnel associated with the United States Economic Development Administration, NOAA, and USPTO.
The Office of Evaluation began preliminary research related to the Program Management Improvement Accountability Act (PMIAA) of 2016. The objective was to determine how HUD has implemented and complied with the requirements of PMIAA. After completing informational interviews with HUD officials and reviewing related documentation, we have determined that a full evaluation is premature at this time because HUD is still implementing key elements of PMIAA
Based on our evaluation of 18 sampled OTFOC contracts and 16 sampled noncompetitive grants awarded in FYs 2020 and 2021, we determined that DHS components complied with applicable guidance when awarding contracts and grants. DHS officials supported award decisions with the required planning, market research, and justification and approval documentation to ensure effective stewardship of taxpayer dollars
This report was issued in conjunction with the Office of Inspector General for the Railroad Retirement Board's Semiannual Report to the Congress. It was incorporated by reference in the corresponding Semiannual Report which is available at the link below.
During this semiannual reporting period, the National Endowment for the Arts (NEA) Office of Inspector General (OIG) completed the Congressionally mandated Financial Statement Audit of the NEA for fiscal year 2022. We also worked with the NEA on the follow-up process, required by the Office of Management and Budget, that resulted in the NEA and awardees taking corrective actions on eleven OIG recommendations – nearly a quarter of open recommendations for the semiannual period. In addition, we resolved 83 percent of the hotline complaints received during the semiannual period, and added two audits to our annual audit plan based on the remaining hotline complaints received.Finally, we continuously monitor NEA’s top management challenges and noted that the NEA continues to make progress in addressing these challenges, and is quick and strategic in responding to new challenges as they occur. In terms of new challenges, NEA has demonstrated its ability to effectively steward increased funding over the past three years. NEA also faces an enhanced role in President Biden’s Executive Order #14084, which includes a whole-of-government approach for advancing the arts, the humanities, and museum and library services. We will include a more thorough discussion of this and other challenges in our next semiannual report.I applaud the NEA and the OIG staff for continuing to press forward and effectively working together. This enabled staff to continue delivering the missions of the Agency and the OIG in a high quality and timely manner.The value-added work that the OIG accomplished this period is due to my staff’s commitment to excellence, continued growth, and dedicated work effort; along with the support of the NEA Chair and her staff. We will continue to work with the NEA Chair and staff to promote economy, efficiency, and effectiveness while helping to ensure integrity, excellence, and value in the delivery of NEA’s mission.
Audit of the Schedule of Expenditures of ORT Israel, Bridges for Peace Program in West Bank and Gaza, Cooperative Agreement 72029419CA00003, January 1 to December 31, 2021
Audit of the Schedule of Expenditures of SAJDI Consulting Engineering Center, Water Engineering Services Project in Jordan, Contract 72027821C00003, January 31 to December 31, 2021
Michael Devine, a former Fire, Life and Safety Assistant Supervisor based in New York, was found guilty on March 15, 2023, of one count of Grand Larceny in the Fourth Degree after a three-day bench trial in the Supreme Court of the State of New York. On April 27, 2023, Devine was sentenced to 400 hours community service and ordered to pay restitution of $2,685 to Amtrak. Devine created counterfeit Amtrak badges for himself and other employees and participated in a scheme with co-workers to use these fake badges and/or their official Amtrak badges to “swipe” each other in and out on Amtrak’s time and attendance machines. Devine resigned on December 10, 2021, and is ineligible for rehire.
Michael Ligotti, D.O., of Delray Beach, Florida, pleaded guilty on October 4, 2022, to conspiring to commit health care fraud for his participation in a $681 million years-long health care fraud scheme throughout Palm Beach County, billing for fraudulent tests and treatments for vulnerable patients seeking treatment for drug and/or alcohol addiction. Amtrak’s health care plan was billed over $535,000 as part of the scheme. On January 9, 2023, Ligotti was sentenced to 20 years in prison. On April 27, 2023, Ligotti’s sentence was amended to include an order of $127,427,988 in restitution.
This Office of Inspector General Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the inpatient and outpatient care provided at the VA Long Beach Healthcare System, which includes the Tibor Rubin VA Medical Center and multiple outpatient clinics in California. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (emergency department and urgent care center suicide prevention initiatives)The OIG issued three recommendations for improvement in two areas:1. Medical staff privileging• Focused professional practice evaluation criteria defined in advance• Medical Executive Council review and evaluation of licensed independent practitioners’ reprivileging request and documentation of review in meeting minutes2. Environment of care• Furniture and equipment kept safe and in good repair
This report presents the results of our evaluation of the U.S. Small Business Administration’s (SBA) handling of cash contributions and gifts. The objective of the evaluation was to determine the adequacy of SBA controls over the solicitation, acceptance, holding, and use of cash contributions and gifts.To meet our objective, we reviewed various management and financial records, applicable laws, regulations, policies, and SBA documents such as financial management system reports and accounting records.We found SBA complied with the Consolidated Appropriations Acts, 2023 and 2022, and SBA regulations and policies regarding soliciting and accepting cash contributions for National Small Business Week 2023 (Business Week). SBA’s Office of Communications & Public Liaison obtained proper approval from the Office of General Counsel for the Business Week cosponsored activity. SBA certified the 10 entities that cosponsored Business Week were vetted through the program offices to ensure no business relationship existed that would cause a conflict of interest.
Financial Closeout Audit of USAID Resources Managed by Centre for the Study of Violence and Reconciliation in Southern Africa Under Cooperative Agreement AID-674-A-14-00016, January 1, 2021, to June 30, 2022
Financial Audit of USAID Resources Managed by Centre for Communication Impact NPC in South Africa Under Multiple Awards, July 1, 2021, to June 30, 2022
Financial Audit of Marie Stopes International Reproductive Choices' Fund Accountability Statement and Cost Sharing Schedule for Fiscal Year Ended December 31, 2019
Financial Audit of USAID Resources Managed by University of Nairobi in Kenya Under Cooperative Agreement 72061521CA00014, April 23, 2021, to June 30, 2022
Financial Audit of USAID Resources Managed by Baylor College of Medicine Children's Foundation Malawi Under Cooperative Agreement 72061221CA00011, October 1, 2021, to June 30, 2022
Evaluation of KLRN Television Compliance with Selected Diversity Requirements Included in the Television Community Service Grants General Provisions and Eligibility Criteria, Report No. ECT2304-2307
The VA Office of Inspector General (OIG) conducted a review to assess implementation and use of VA Video Connect (VVC) prior to and during the COVID-19 pandemic. The OIG explored why providers used telephone communication more frequently than VVC at the onset of the pandemic and how the Veterans Health Administration (VHA) resolved technology issues. Experiences of a subset of providers who used VVC from October 2016 through July 2021 were examined to identify benefits of and barriers to VVC use.VHA leaders did not specify a pandemic in the telehealth strategic plans but identified the exigent nature of the pandemic in the March 2020 COVID-19 Response Plan, which served as the impetus for VVC utilization and sustainability.The OIG’s review of presumed in-person, telephone, and VVC encounters found VVC encounter use increased prior to the pandemic but was the least used modality of care; telephone and VVC encounter use increased as presumed in-person encounters decreased at the onset of the pandemic; and telephone encounter use decreased and presumed in-person and VVC encounters continued to increase following the initial months of the pandemic.VHA telehealth strategic plans focused on improving technology to support VVC, increasing provider capability, and identifying preparations for the provision of health care remotely. However, VHA was not readily able to support the increased demand of VVC use. During provider interviews, providers stated the pandemic served as a turning point; identified benefits of using VVC, such as convenience and increased patient engagement; and described barriers to VVC use such as patient obstacles with VVC technology, VVC appointments not emulating in-person appointments, and provider difficulty with scheduling VVC appointments.The OIG made three recommendations to the Under Secretary for Health related to provider knowledge and utilization of VVC technology, clinical and administrative support, and VVC scheduling processes.
Our objective was to review cash and stamp inventory, daily reporting activities, clock ring adjustments, and employee separations at Hillcrest Station. Our audit scope was July 1, through December 31, 2022.
Our objective was to review cash and inventory, daily reporting activities, clock ring adjustments, and employee separations at the Rancho Santa Fe Post Office. The scope period was July 1 through December 31, 2022.
Our objective was to review cash and inventory, daily reporting activities, clock ring adjustments, and employee separations at the Chula Vista Post Office. The scope period was July 1, through December 31, 2022.
What We Looked AtThe Federal Aviation Administration (FAA) has historically maintained an excellent safety record. However, two fatal accidents in 2018 and 2019 involving the Boeing 737 MAX 8 raised concerns about FAA's oversight and certification of civilian aircraft manufactured and operated in the United States. At the request of Secretary of Transportation Elaine L. Chao and several members of Congress, our office has undertaken a series of reviews related to FAA's certification of the MAX and its safety oversight. This is the third report in that series. It focuses on FAA's risk assessments following the accidents, as well as the recertification and return to service efforts for the MAX. Accordingly, our audit objective was to evaluate FAA's processes and procedures for grounding aircraft and implementing corrective actions, including for the MAX 8. Specifically, we evaluated FAA's risk assessment processes following the accidents, and the Agency's process for returning the airplane to service.What We FoundFAA's steps following the accidents were in line with its overall post-event risk assessment processes; however, we identified some areas that may impact the Agency's response in the future. First, FAA's processes, by design, allow for significant flexibility in order to factor in the judgment of engineers. Second, FAA has not updated the underlying order and related guidance for its post-event risk assessment processes in over a decade. Third, the Agency lacks quantifiable human factors data, such as pilot reactions to non-normal situations. Finally, FAA's engineers are not all following or receiving the same guidance or training. As a result, FAA may not be able to ensure it consistently follows the most effective risk assessment processes following a safety event.FAA completed the recertification of the 737 MAX on November 18, 2020. During the recertification process, the Agency retained regulatory compliance findings for the design changes instead of delegating them to Boeing's Organization Designation Authorization (ODA) program. Numerous complex issues from multiple safety reviews prompted FAA to require Boeing to submit a document demonstrating the effects of Boeing's proposed changes on the speed trim system and how those changes affected the safe operation of the MAX. While FAA is incorporating many of the lessons learned from the MAX recertification efforts for future projects, there are still improvements and procedures currently being codified by the Agency.Our RecommendationsWe made seven recommendations to improve FAA's processes for risk assessment and determination of corrective actions. FAA concurred with all our recommendations and provided appropriate actions and planned completion dates.
This report was submitted to the Comptroller General in accordance with Section 5 of the Government Accountability Office (GAO) Act of 2008. The report summarizes the activities of GAO's Office of Inspector General (OIG) for the six-month reporting period ending March 31, 2023. During the reporting period, the OIG provided Congress with its legislative priorities which will improve transparency and enhance its independence by providing parity with other federal Inspectors General.The OIG also initiated work on one performance audit and continued work on three additional performance audits. In addition, the OIG closed nine investigations and opened 11 new investigations. The OIG processed 32 substantive hotline complaints, many of which were referred to other OIGs for action because the matters involved were within their jurisdictions.The OIG remained active in the GAO and OIG communities by briefing new GAO employees on its audit and investigative missions, briefing GAO teams on the work of the GAO OIG, and participating in committees and working groups of the Council of the Inspectors General on Integrity and Efficiency, including those related to the Pandemic Response Accountability Committee.
This evaluation focused on EPA Region 9’s oversight of authorized Hawaii state programs for underground storage tanks and drinking water quality and the response to the Red Hill drinking water contamination incident.
Investigative Summary: Findings of Misconduct by an Assistant United States Attorney for Sexually Inappropriate Comments to Multiple Colleagues and Attempted Witness Tampering
Our objective was to evaluate the U.S. Postal Service’s management of the HCR late trip payment process. To accomplish our objective, we selected three samples of late trip payment transactions to review for accuracy of the payments. The first was a statistical sample of 208 of the 52,446 payment transactions for FY 2021 and FY 2022. The second was a judgmental sample of 55 transactions greater than 200 hours late. The last was a judgmental sample of 163 of the 1,629 lump sum payment transactions.
Financial Audit of Millennium Challenge Corporation Resources Managed by Millennium Development Authority and Millennium Challenge Compact Between Millennium Challenge Corporation and the Government of Ghana, for April 1, 2020 to March 31, 2021
For our evaluation of the National Telecommunications and Information Administration’s (NTIA’s) plans for implementation of three new broadband grant programs under the Consolidated Appropriations Act, 2021 (CAA or the Act), our objective was to determine whether NTIA complied with the requirements of the Act. Specifically, we determined (1) what steps NTIA took to award and disburse funds, (2) the challenges faced during implementation, and (3) the status of awarding and disbursing funds under the CAA. We found that NTIA took steps to implement the CAA requirements and mitigate the impact of the challenges faced. As of March 2, 2023, NTIA awarded $1,528,642,673—or approximately 96 percent of the funds appropriated by the CAA.
Medicare Could Have Saved Up To $128 Million Over 5 Years if CMS Had Implemented Controls To Address Duplicate Payments for Services Provided to Individuals With Medicare and Veterans Health Administration Benefits
The National Nuclear Security Administration’s (NNSA) Molybdenum-99 (Mo-99) program objective is to accelerate the establishment of a reliable non-highly enriched uranium-based Mo-99 production capability in the U.S. sufficient to supply the U.S. Mo-99 demand as soon as possible. The supply should rely on diversified technologies that utilize a variety of facilities to ensure that patients in the U.S. have access to the Mo-99 they need without interruption. To achieve this objective, in 2018, a new Funding Opportunity Announcement was issued by NNSA’s Office of Material Management and Minimization for Mo-99 production without the use of highly enriched uranium for a 50-50 percent cost-sharing arrangement between the U.S. Government and each recipient of Federal funding in support of commercial application demonstration projects. Based on NNSA’s review of the awardees’ technical capacity and ability to adequately fund their cost share to bring their projects to commercial production and become long-term producers in the U.S., it awarded four cooperative agreements.We initiated this audit to determine if NNSA administered the Mo-99 cooperative agreements with commercial companies in accordance with applicable program requirements.We reviewed four cooperative agreements and found that NNSA generally administered the agreements in accordance with applicable requirements. However, NNSA did not always ensure that compliance audits were performed, as required, when expenditures exceeded $750,000. Specifically, an awardee with expenditures totaling $10,258,447.83 did not have an audit completed, as required; therefore, these costs are pending the completion of compliance audits. In addition, we found that NNSA has an opportunity to improve its internal controls related to the invoice approval process by ensuring that alternate personnel assigned to the task understand and follow the established process. We are questioning approximately $34,313 of costs paid to the awardee due to erroneous charges. Finally, we found that NNSA did not document its risk evaluation of an awardee to include how the results of the pre-award survey factored into the risk evaluation.These issues occurred because (1) NNSA does not have a policy to monitor and ensure that awardees are complying with audit requirements; (2) an alternate Contracting Officer did not follow NNSA’s internal invoice approval process and approved the invoice without a thorough invoice review; and (3) NNSA does not have a policy for formally documenting high-risk recipients and any special award conditions.To address the issues identified in this report, we have made three recommendations that, if fully implemented, should help ensure that NNSA’s administration of cooperative agreements complies with applicable regulations and policies. Management fully concurred with two of the three recommendations and concurred in principle with the other recommendation. Management also identified responsive corrective actions to address the associated report issues.
Letter to Congress: Office of Inspector General 2023 Review of the NCUA’s 2022 Compliance Under the Payment Integrity Information Act of 2019 (PIIA), April 24, 2023
Our objective was to determine whether expenditures by the Board of Governors were properly supported and reasonable and complied with Postal Service and Board policies and procedures. We reviewed all payments made to governors for salaries and meeting fees, totaling $318,133, as well as 83 of 261 Board expenditures, totaling $162,960 of $216,314.
We performed this review to highlight prior audit findings about the U.S. Environmental Protection Agency’s administration and oversight of congressional earmarks to inform the Agency’s management of earmarks in the fiscal year 2022 budget.
The VA Office of Inspector General (OIG) reviewed how the Medical Disability Examination Office (MDEO) is monitoring mileage requirements in the contract exam process because veterans reported on satisfaction surveys that they had to travel excessive distances to attend exams.Contracts with providers require that veterans expressly consent to traveling farther for exams than the set limits: 50 miles for non-specialist exams and 100 miles for specialist exams. That express consent must be documented and included in the record available to Veterans Benefits Administration (VBA) employees.The OIG found MDEO is not monitoring whether vendors obtain and document veterans’ express consent to travel beyond contractual mileage limits for exams. The OIG also found MDEO is not sufficiently monitoring vendor portals to ensure all required details of mileage reimbursements are available to veterans. MDEO is not monitoring compliance because its leaders do not consider it a priority given the small percentage of veterans affected. However, MDEO is responsible for ensuring vendors comply with all contract requirements, including mileage requirements and reimbursements. Without monitoring, VBA cannot identify or implement improvements that will make a positive impact for veterans.If vendors do not obtain and document express consent to exceed contractual mileage limitations, veterans may not be aware of their right to undergo an exam within a reasonable distance of their homes. This potentially burdens veterans who are elderly or have disabilities that make it difficult to travel long distances.The OIG recommended the under secretary for benefits implement a process to monitor and demonstrate progress in assessing vendors’ compliance with contractual mileage and travel reimbursement requirements, collaborate with vendors to ensure portals include proper documentation of express consent, and collaborate with vendors to ensure mileage reimbursement information is available in vendor portals.
DOJ Press Release: Monmouth County Pair Indicted for Fraudulently Obtaining More Than $3.75 Million in Loans Meant to Help Small Businesses During COVID-19 Pandemic
Our objectives were to examine the distribution of resources for maintenance and repairs at retail facilities in lower- and higher-income communities and assess the impact of the retail portion of the DFA plan on these communities. This review was initiated in response to a Congressional request. We analyzed repair and maintenance data to identify funds expended, conducted observations at 48 judgmentally selected retail sites, and interviewed Postal Service officials.
Audit of the Bureau of Alcohol, Tobacco, Firearms and Explosives’ Risk-Based Inspection Selection Processes and Administrative Actions Issued to Federal Firearms Licensees
Audit of the Schedule of Expenditures of AECOM Technical Services Inc., USAID West Bank and Gaza Architecture and Engineering Services Project, Contract AID-294-I-16-00001, Task Order AID-294-TO-16-00012, October 1, 2020, to September 30, 2021
Financial Audit of USAID Resources Managed by HIV SA NPC in South Africa Under Cooperative Agreement 72067418CA00031, October 1, 2021, to September 30, 2022
Financial Audit of USAID Resources Managed by Baylor College of Medicine Children's Foundation Uganda Under Multiple Awards, July 1, 2021, to June 30, 2022
This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the leadership performance and oversight by Veterans Integrated Service Network 9: VA MidSouth Healthcare Network in Nashville, Tennessee. This evaluation focused on five key areas of clinical and administrative operations:• Leadership and organizational risks• Quality, safety, and value• Medical staff credentialing and privileging• Environment of care• Mental health (focusing on suicide prevention)The OIG issued three recommendations for improvement in the environment of care area:• Comprehensive Environment of Care compliance report• Comprehensive Environment of Care Compliance and Assessment Tool data• Emergency Management Committee’s annual review of the Veterans Integrated Service Network-wide strengths, weaknesses, priorities, and requirements for improvement
An Assistant Supervisory Plumber based in New York, New York, violated Amtrak policy by engaging in outside employment at two construction companies while on Family Medical Leave Act (FMLA) and receiving Railroad Retirement Board benefits. The employee resigned in lieu of his disciplinary hearing and is ineligible for rehire.
As part of our annual audit plan, we performed an audit of costs billed to the Tennessee Valley Authority (TVA) by the Steam Generating Team, LLC (SGT) for steam generator replacement services under Contract No. 11144. Our audit objective was to determine if costs were billed in accordance with the contract's terms. Our audit scope included approximately $35.9 million in costs paid by TVA from January 1, 2020, through January 31, 2022.In summary, we determined SGT overbilled TVA $1,903,315 including:$1,163,835 in ineligible overhead and fee markups applied to services, equipment, and other costs provided by TVA under the contract. $689,748 in labor costs, including:$685,880 for labor billing rates that exceeded adjusted rates that had been approved through the contract's change order process. In addition, we found the adjusted rates were never incorporated into the contract's pricing schedules.$1,304 for unsupported labor costs.$2,564 for ineligible labor costs.$38,579 in travel costs, including (1) $37,316 in duplicate costs and (2) $1,263 in ineligible costs. $11,153 in miscellaneous costs for ineligible subscription renewals.(Summary Only)
Audit of the Office of Justice Programs Victim Assistance Funds Subawarded by the Virginia Department of Criminal Justice Services to the Alexandria Sexual Assault Center and Domestic Violence Program, Alexandria, Virginia
Our objective was to assess the Postal Service’s ongoing actions to reduce non-career employee turnover rates. For this audit, we reviewed non-career employee turnover and retention for fiscal years (FY) 2019 through 2022, nationwide. We conducted site visits to 26 judgmentally selected facilities where we held interviews to identify underlying causes of non-career employee turnover. In addition, we interviewed headquarters personnel regarding their responsibilities, processes, and procedures on non-career employee retention strategies and initiatives.
Audit of the Schedule of Expenditures of Appleseeds Academy, Rise Together Program in West Bank and Gaza, Cooperative Agreement 72029420CA00003, June 27, 2020 to December 31, 2021
Financial Audit of USAID Resources Managed by World Wild Fund for Nature South Africa in Multiple Countries Under Cooperative Agreement AID-674-A-17-00006, July 1, 2021, to June 30, 2022
Audit of the Schedule of Expenditures of USAID Awards Under Contract AID-OAA-TO-15-00010; Managed by Chemonics International, Inc., Global Health Supply Chain Management - PRH Program in Afghanistan, January 1, 2019 to December 31, 2020
Audit of the Fund Accountability Statement of Costs Incurred by People In Need in Connection With USAID Resources of Twelve Programs Implemented In Syria, Ukraine, Afghanistan, Myanmar and Nicaragua for the Fiscal Year Ended December 31, 2019
Financial Audit of Millennium Challenge Corporation (MCC) Resources Managed by Millennium Challenge Account-Nepal, Under the Compact Agreement Between MCC and the Government of Nepal, for the period April 1, 2021, to September 30, 2021
Financial Audit of Millennium Challenge Corporation Resources Managed by Millennium Challenge Account-Cte d'Ivoire, Under the Compact Agreement Between MCC and the Government of Cte d'Ivoire, for the period from October 1, 2020 to March 31, 2021
Financial Audit of USAID Resources Managed by University of Nairobi Enterprises and Services Limited in Kenya Under Cooperative Agreement AID-615-A-16-00013, July 1, 2021, to June 30, 2022
DHS’ information security program for FY 2022 was rated “effective,” according to this year’s reporting instructions. We based this rating on our evaluation of DHS’ compliance with the FISMA requirements on unclassified and National Security Systems, for which DHS improved its maturity level in three functions compared to FY 2021. DHS received “Level 4 – Managed and Measurable” in the Identify, Protect, Respond, and Recover functions, and a “Level 3 – Consistently Implemented” in the Detect function.