Federal Reports

What We Looked AtIn accordance with the Government Corporation Control Act of 1945, we audited the financial statements of the Saint Lawrence Seaway Development Corporation (SLSDC), a U.S. Government Corporation, as of and for the fiscal years ended September 30, 2020, and September 30, 2019. What We FoundIn our opinion, SLSDC’s financial statements present fairly, in all material respects, SLSDC’s financial position as of September 30, 2020, and September 30, 2019, and its operations and changes in cumulative results of operations, cash flows, budgetary resources and actual expenses, and changes in equity of the U.S. Government for the years then ended, in accordance with U.S. generally accepted accounting principles. We found no material weaknesses in internal control over financial reporting based on the limited procedures we performed. We also found no reportable noncompliance for fiscal year 2020, with provisions of the applicable laws, regulations, and contracts we tested. RecommendationsWe are making no recommendations.

The Chief Financial Officers Act of 1990 (Public Law 101-576), as amended, requires the Office of Inspector General to audit the financial statements of the Federal Housing Administration (FHA) annually. We audited the accompanying FHA financial statements and notes as of and for the fiscal years ending September 30, 2020 and 2019, which are comprised of the balance sheets, related statements of net cost, changes in net position, and combined statements of budgetary resources for the fiscal years then ended. We conducted these audits in accordance with U.S. generally accepted government auditing standards.In our opinion, FHA’s fiscal years 2020 and 2019 financial statements were presented fairly, in all material respects, in accordance with the U.S. generally accepted accounting principles for the Federal Government. FHA reports our opinion in its Fiscal Year 2020 Annual Management Report. The results of our audit of FHA’s principal financial statements and notes for the fiscal years ending September 30, 2020 and 2019, including our report on FHA’s internal control and test of compliance with selected provisions of laws, regulations, and contracts applicable to FHA, are presented in this report. Our audit did not disclose any deficiencies in internal control that we consider to be material weaknesses or significant deficiencies and no instances of noncompliance with applicable laws, regulations, and contracts.We have no new recommendations in this report; however, the Followup on Prior Audits section contains recommendations from prior-year audits that are still outstanding. While these recommendations relate to prior-year material weaknesses or significant deficiencies that have now been substantially resolved, FHA should continue to track and resolve these recommendations in accordance with departmental procedures.

The Medicaid ProgramState Medicaid managed care programs are intended to increase access to and improve the quality of health care for Medicaid beneficiaries. States contract with an MCO to make services available to enrolled Medicaid beneficiaries, usually in return for a periodic payment, known as a capitation payment. Federal Requirements States must generally provide notice when the State agency terminates a Medicaid beneficiary’s covered benefits or eligibility at least 10 days before the date of action (42 CFR § 431.211). However, if a State establishes that the beneficiary has been accepted for Medicaid services by another State, the original State must provide notice of the termination of the beneficiary’s benefits or eligibility no later than the date of the termination (42 CFR § 431.213(e)). Ohio’s Medicaid Managed Care ProgramDuring our audit period, approximately 90 percent of Ohio’s Medicaid population received benefits through MCOs under contract with the State agency. The contracts with the MCOs covered health care services to eligible Medicaid beneficiaries in exchange for a fixed per-member, per-month capitation payment. The Medicaid MCO contracts incorporate rules set forth in the Ohio Administrative Code (OAC) (State agency managed care contracts Article XIV), which requires the State agency to disenroll a beneficiary from an MCO plan when the beneficiary’s permanent residence moves outside the plan’s service area (OAC 5160-26-02.1(B)(1) and OAC 5160-58-02.1(A)(2)). Disenrollment must take effect on the last day of the month in which the beneficiary moves (OAC 5160-26-02.1(B)(1) and OAC 5160-58-02.1(A)(2)). Transformed Medicaid Statistical Information SystemThe Transformed Medicaid Statistical Information System (T-MSIS) is a critical data and systems component maintained by CMS. The primary purpose of T-MSIS is to establish an accurate, current, and comprehensive database containing standardized enrollment, eligibility, and paid claim data about Medicaid recipients to be used for the administration of Medicaid at the Federal level, and assist in the detection of fraud, waste, and abuse in Medicaid.Public Assistance Reporting Information SystemThe Public Assistance Reporting Information System (PARIS) is an information exchange system managed by the Administration for Children and Families. PARIS matches State and Federal data to provide State Public Assistance Agencies with beneficiary information that they can use to identify possible concurrent eligibility and erroneous payments. Ohio’s Medicaid eligibility verification plan describes the use of PARIS as a post-eligibility check for concurrent benefits received in another State while the individual is enrolled in Ohio Medicaid. The PARIS match information is added to Ohio’s eligibility system and generates an electronic alert (PARIS alert) for beneficiaries who were identified as having concurrent eligibility in another State. The State agency is required to contact the beneficiaries before eligibility may be terminated. If the State agency receives information that may affect a beneficiary’s Medicaid benefits, such as a PARIS alert, the State agency sends a PARIS Contact Notice to the beneficiary, and the beneficiary has 10 days to respond. If the beneficiary doesn’t respond, a county caseworker sends out a reminder letter. If there is no response from the beneficiary or if mail addressed to the beneficiary is returned from the post office with no forwarding address, the beneficiary’s eligibility may be terminated. If the State agency confirms that the beneficiary has been determined eligible for Medicaid in another State, the State agency is not required to provide advance notice and may send notice on the effective date of the beneficiary’s eligibility termination.

This audit is part of a series of hospital compliance audits. Using computer matching, data mining, and other data analysis techniques, we identified hospital claims that were at risk for noncompliance with Medicare billing requirements. For calendar year (CY) 2017, Medicare paid hospitals $206 billion, which represents 55 percent of all fee-for-service payments; accordingly, it is important to ensure that hospital payments comply with requirements.Our objective was to determine whether Edward W. Sparrow Hospital (the Hospital) complied with Medicare requirements for billing inpatient and outpatient services on selected types of claims.

The OIG investigated an allegation that a National Park Service (NPS) employee misused an assigned Government Owned-Vehicle (GOV) by taking it home overnight on multiple occasions without authorization.We found that the employee routinely used the assigned GOV as a home-to-work vehicle without prior, written authorization as required by 41 C.F.R. § 102.5 and NPS policy.

We are pleased to present the Top Management Challenges Report. In accordance with the Reports Consolidation Act of 2000, the Inspector General reports on the most serious management and performance challenges facing the U.S. AbilityOne Commission. We illustrate new challenges such as the challenge to effectively allocate scarce resources rather than lack of resources and we included continuous work on financial management as a challenge for this year. The Commission designates Central Nonprofit Agencies (CNAs) to facilitate employment of people who are blind of have significant disabilities. the dynamics of the CNAs in the program are changing and growing. Our reporting reflects on, and seeks to assist in, this challenging environment.In this year's Top Management and Performance Challenges Report we include the most pressing challenges: 1) allocation of roles, resources and responsibilities 2) implementation of 898 panel recommendations, 3) Anti-deficiency Act violations, 4) transparency, 5) erosion of statutory program authority, 6) implementation of cooperative agreements, 7) a lack of risk management, and 8) needed enhancements to program compliance.

An Amtrak locomotive technician based in Seattle, Washington, was terminated from employment on November 12, 2020, following his administrative hearing. Our investigation found that the former employee violated company policies by driving a company-owned vehicle without a valid driver’s license on at least two occasions. We also found that the former employee failed to report an arrest and subsequent conviction to the company for a driving under the influence violation as required by company policy.

In accordance with the Reports Consolidation Act of 2000, we are submitting what we have determined to be the most significant management and performance challenges facing the U.S. Department of the Interior (DOI), for inclusion in the DOI’s Agency Financial Report for fiscal year 2020.Given the broad effects of the COVID-19 pandemic on not only the DOI but the United States as a whole during this fiscal year, we have modified our approach for this year’s report to feature a detailed analysis of the DOI’s pandemic response. We are not suggesting that the challenges we identified in previous years have been resolved, but, under the circumstances, we believe that they should be viewed in light of the pandemic and its substantial effect on the DOI.We also identify an emerging issue—namely, the implementation of the Great American Outdoors Act—and the DOI’s progress in preparing for and addressing this challenge.This report is primarily based on Office of Inspector General (OIG) and U.S. Government Accountability Office (GAO) reviews (including the GAO’s High-Risk List), as well as our general knowledge of the DOI’s programs and operations.