Federal Reports

What We Looked AtBetween 2009 and 2011, Congress cumulatively appropriated $10.2 billion for the High Speed Intercity Passenger Rail (HSIPR) program. As of April 2019, the Federal Railroad Administration (FRA), responsible for this program, has disbursed $8.5 billion of those funds, with approximately 35.5 percent dedicated to developing a corridor in California, managed by the California High Speed Rail Authority (CHSRA). The former Chairman of the House Committee on Transportation and Infrastructure, Subcommittee on Railroads, Pipelines, and Hazardous Materials requested that we review FRA’s risk mitigation and oversight of expenditures. Accordingly, our audit objectives were to assess FRA’s (1) risk analysis, assessment, and mitigation efforts—particularly regarding the availability of non-Federal matching funds, business plans, and financial reporting—and (2) procedures for determining whether Federal funds expended complied with applicable Federal laws and regulations. Due to the significant amount of HSIPR funds dedicated to California, our audit focused on FRA’s cooperative agreements with CHSRA. What We FoundWhile FRA took numerous actions to oversee the CHSRA agreement, FRA missed opportunities to better assess and mitigate Federal risks. Specifically, while FRA routinely found that CHSRA submissions of required planning documents were insufficient and provided CHSRA with technical assistance to improve future submissions, prior to May 2019, FRA did not document decisions on additional actions to address the repeated shortcomings. Additionally, FRA’s review of documents submitted by CHSRA did not verify underlying methodologies used to create them or make an independent assessment of their plausibility. FRA did not define minimum standards for the acceptable interim use of the project’s Central Valley segment to ensure that the initial construction segment would have independent operational utility, or ensure that CHSRA developed an acceptable interim use plan—although CHSRA missed the deadline to provide one. Finally, FRA’s review of project reimbursement requests relied on documentation that was not adequate to verify that expenditures met Federal requirements, and FRA’s review of expenditure documentation was inadequate in some cases. Our RecommendationsWe made four recommendations to improve FRA’s assessment and mitigation of risks, documentation of decisions, and processes for overseeing expenditures. FRA concurred with three recommendations and partially concurred with one. We consider all four recommendations resolved but open pending completion of planned actions.

The Office of the Inspector General conducted a review of Hydro Generation, Raccoon Mountain (Hydro RM) to identify operational and cultural strengths and risks that could impact Hydro RM’s organizational effectiveness. Our report identified strengths within Hydro RM related to (1) organizational alignment, (2) positive interactions within and outside of Hydro RM, (3) effective leadership, and (4) positive ethical culture. However, we also identified risks that could impact Hydro RM’s ability to meet its responsibilities in support of PO’s mission. These were comprised of risks related to (1) an employee’s behaviors that are inconsistent with TVA’s Values, (2) inadequate staffing, and (3) outage execution and management.

The objective for this report was to identify current risks to launching revenue service of Amtrak’s $2.1 billion Acela 21 program on schedule and reassess the company’s oversight of the program.We found that the company has instituted some key program management practices for the Acela 21 program to correct earlier problems and avoid those it experienced in other recent, major acquisitions. Nevertheless, the program has no schedule cushion left, not only because of manufacturer delays in delivering the trainsets, but also because of other management weaknesses. Specifically, key program officials have had competing responsibilities, constraining their ability to undertake the Acela 21 program, and the program sponsor’s authority to make decisions and task key program officials is not clearly defined. This affects the program sponsor’s ability to ensure problems are addressed in a timely manner.Additionally, we found multiple indicators that signal the potential for further delays—some outside of the company’s control—across five critical program elements. Company executives acknowledged that all five program elements would need to proceed nearly flawlessly to ensure on-time revenue launch in 2021. The company, however, has discussed, but not developed a full range of contingency plans to respond to delays.To address the findings in our report, we recommend the company ensure key program officials have sufficient capacity so that competing responsibilities do not interfere with their ability to complete program tasks in a timely manner. We also recommended that it assess the extent to which the program sponsor had the authority to task key program officials and make decisions necessary to resolve problems and to address any gaps in this authority. Finally, we recommended that it task the program management team with developing additional contingency plans and assessing their operational and financial impacts.

The VA OIG conducted a healthcare inspection to assess allegations of delays in providing patient test results, communication issues between providers and paramedics related to transporting patients to a community hospital emergency department, violations of the Emergency Medical Treatment and Labor Act, and quality of care concerns resulting from paramedic care at the Bath VA Medical Center (facility). The OIG substantiated a surrogate provider failed to follow test notification policies when a patient received positive stress test results 36 days after the test; however, the patient did not experience an adverse event as a result. The OIG substantiated a paramedic failed to comply with the facility’s standard operating procedure when the paramedic transported a patient to the nearest community hospital rather than one instructed by the provider. The provider recommended a hospital that was further because the nearest one lacked the necessary equipment to complete the patient evaluation. The OIG team noted that the facility’s transfer policy did not clearly define a process for outpatient transfers to a higher level of care utilizing facility paramedics. The OIG did not substantiate that facility paramedics violated the intent of the law by transporting patients to a community hospital emergency department. Facility providers medically screened and provided care to the patients prior to transfer. The OIG did not substantiate that facility paramedics provided poor quality of care to the reviewed patients. The paramedics asked suitable and clarifying questions of the providers, assessed the patients, and documented their findings. The OIG made two recommendations to the Facility Director to ensure that surrogate providers comply with their responsibilities to notify patients of test results when providing coverage and to ensure that the Patient Transfer Policy clearly defines a process for outpatient transfers to a higher level of care utilizing facility paramedics.

The enclosed report presents the results of the audit of the Commission’s financial statements for the fiscal year ended September 30, 2019

The Coverage Gap Discount Program (CGDP) made manufacturer discounts equal to 50 percent of the negotiated price of applicable, covered Part D drugs available to Medicare Part D beneficiaries during calendar years (CYs) 2011 through 2018. During CYs 2013 and 2014, Coverage Gap discounts totaled more than $4.5 billion and $4.7 billion, respectively.

The U.S. Department of Health and Human Services (HHS), National Institutes of Health (NIH), is subject to Federal audits of its internal activities as well as Federal and non-Federal audits of activities performed by its grantees and contractors. As a followup to these audits, NIH is responsible for resolving Federal and non-Federal audit report recommendations related to its activities, grantees, and contractors within 6 months after formal receipt of the audit reports. HHS, Office of Inspector General (OIG), prepares and forwards to NIH monthly stewardship reports that show the status of these reported audit recommendations.

An Amtrak senior employee in Los Angeles, California, was terminated from employment on January 21, 2020, and a Los Angeles-based senior employee in Mechanical Operations was issued a written reprimand on the same date following the issuance of our investigative report. Our investigation found that the senior employee solicited money and accepted gifts from company contractors. Our investigation also found that the senior employee in Mechanical Operations misused company equipment and email when proposing a personal business venture with a company contractor.