Federal Reports

What We Looked AtWe reviewed the Los Angeles County Metropolitan Transportation Authority's single audit report for the fiscal year ended June 30, 2018, in order to identify findings that affect directly awarded Department of Transportation programs. An independent auditor prepared the single audit report, dated December 19, 2018.What We FoundWe found that the report contained a subrecipient monitoring finding that needs prompt action from the Federal Transit Administration's (FTA) management.RecommendationsWe recommend that FTA ensures that the Authority complies with the subrecipient monitoring requirements.

What We Looked AtWe reviewed the Terre Haute Regional Airport Authority's single audit report for the fiscal year ended December 31, 2017, in order to identify findings that affect directly awarded Department of Transportation programs. An independent auditor prepared the single audit report, dated March 8, 2019.What We FoundWe found that the report contained a special tests and provisions finding, and an allowable costs/cost principles and reporting finding that need prompt action from the Federal Aviation Administration's (FAA) management.RecommendationsWe recommend that FAA ensures that the Authority complies with the special tests and provisions and allowable costs/cost principles and reporting requirements.

OIG data analytics identified the Newport, KY, Post Office with the highest amount recorded to Account Identifier Code (AIC) 553, Refund Postage and Fees, during fiscal year (FY) 2019, Quarter (Q) 3 in the Ohio Valley District (57 percent of district total of $70,023). During this period, this unit reported a total of $39,581, which is a significant increase from FY 2019 Q1 total of $167 and Q2 total of $12.2 In addition, the refunds in AIC 553 for the same period in FY 2018 was $94. The objective of this audit was to determine whether postage and fee refunds were valid, properly supported, and processed at the Newport Post Office.

This evaluation examines data and oversight related to Part D pharmacy rejections and coverage denials that, when issued for avoidable or inappropriate reasons, can lead to delays in beneficiary access to needed drugs. Part D is an optional benefit that helps beneficiaries pay for medically necessary prescription drugs. However, Part D's shared-risk payment model can create an incentive for sponsors to deny requests for prescription drugs in an attempt to increase profits. Because Part D covers more than 45 million beneficiaries, even low rates of denied or delayed medically necessary drugs or reimbursement could contribute to physical or financial harm for Medicare beneficiaries.

Ensuring the accuracy of manufacturer-reported average manufacturer prices (AMPs) and best prices (BPs) is vital given that these prices are the primary benchmarks that the Federal Government uses to calculate the rebates and discounts available to Medicaid and certain safety-net providers. In the absence of guidance to the contrary, CMS allows manufacturers to make "reasonable assumptions" that are consistent with statute and regulation when they calculate rhe AMPs and BPs for Medicaid-covered drugs. Previous OIG work has shown that manufacturers have made different assumptions when including or excluding certain sales in their price calculations, potentially leading to significantly lower or higher AMPs and BPs. AMPs and BPs are used to calculate the amount of rebates that manufacturers must pay to Medicaid. A lower AMP for example, could reduce the rebate amount that a manufacturer must pay, thus increasing net costs for Medicaid. In addition, AMPs and BPs are also used to establish the prices paid by health care entities eligible for the 340B Drug Discount Program. In September 2016, Congress asked OIG to examine CMS's oversight of the Medicaid Drug Rebate Program. This report is the last of three OIG evaluations related to this request.

The opioid crisis is a public health emergency. There were 47,600 opioid-related overdose deaths in the United States in 2017. As part of its efforts to address this crisis, OIG has assessed opioid use in Medicare Part D nationwide and in specific areas, such as the Appalachian region. This data brief focuses on Missouri and provides Statewide data of opioid utilization in Medicare Part D. These data are particularly important for Missouri, as it is the only State that does not currently have a Statewide prescription drug monitoring program.

S&T did not fully comply with requirements of the Homeland Security Act of 2002, as amended, by not effectively coordinating and integrating department-wide R&D activities. In August 2015, S&T established IPTs as the central mechanism to identify, track, and coordinate department-wide priority R&D efforts. However, S&T did not follow its IPT process as intended.