Federal Reports

When Congress established average sales price (ASP) as the basis for reimbursement for Medicare Part B drugs (generally, drugs that are injected or infused in physicians’ offices or hospital outpatient settings), it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts. The Social Security Act (the Act) mandates that OIG compare ASPs with average manufacturer prices (AMPs). If OIG finds that the ASP for a drug exceeds the AMP by a certain percentage (currently 5 percent), the Act directs the Secretary of Health and Human Services to substitute the ASP-based payment amount with a lower calculated rate. Through regulation, CMS outlined that it would make this substitution only if the ASP for a drug exceeded the AMP by 5 percent in the two previous quarters or three of the previous four quarters.

When Congress established average sales prices (ASPs) as the basis for Medicare Part B drug reimbursement, it also provided a mechanism for monitoring market prices and limiting potentially excessive payment amounts. Generally, Part B-covered drugs are those that are injected or infused in physicians' offices or hospital outpatient settings. The Social Security Act (the Act) mandates that OIG compare ASPs with average manufacturer prices (AMPs). If OIG finds that the ASP for a drug exceeds the AMP by a certain percentage (currently 5 percent), the Act directs the Secretary of Health and Human Services to substitute the ASPbased payment amount with a lower calculated rate. Through regulation, CMS outlined that it would make this substitution only if the ASP for a drug exceeds the AMP by 5 percent in the two previous quarters or three of the previous four quarters.

We identified debris removal contract performance issues and concerns. In the report, we discuss our observations regarding the use of pre-disaster debris removal contracts in Florida following Hurricane Irma. We also emphasize how FEMA can benefit from implementing effective controls to track systemic issues after a disaster and ensure FEMA follows procedures for uploading required documentation to support debris removal costs for proper grant management. The report contains no recommendations.

The OIG investigated allegations that a U.S. Fish and Wildlife Service (FWS) manager accepted gifts from prohibited sources, awarded contracts to personal friends, directed improper credit card purchases, and violated travel regulations.We did not find evidence that the manager’s actions violated ethics, procurement, or travel regulations as alleged.

We investigated whether career U.S. Department of the Interior (DOI) staff were directed to delay releasing documents responding to a Freedom of Information Act (FOIA) request that was being litigated in U.S. district court, and whether withholding these documents conflicted with the court’s order to the DOI to review a certain number of potentially responsive pages every month.We found that after David Bernhardt’s nomination for Interior Secretary was announced on February 4, 2019, then Counselor to the Secretary Hubbel Relat directed career DOI staff to temporarily withhold documents related to Bernhardt from a release of FOIA documents scheduled to occur under the court order. As a result, 253 pages of information were not included in the scheduled release, but most of those pages were released later in 2019. Accordingly, we have determined that this matter does not warrant further investigation and that the court is the proper venue to determine whether the DOI met its obligations under the court order.

As a part of our IT Audit program, the OIG reviewed a Postal Service IT system to assess the security posture. This audit involved a technical review to identify potential issues and provide recommendations. The technical details of our work are shared directly with Postal Service management. Due to the sensitive nature of this information, we did not post details of our work.