Federal Reports

Based on our data analysis of miscellaneous services for fiscal year (FY) 2019, Quarter (Q) 2, we determined the Dickinson MPO made local purchases and payments totaling $7,060. This is a significant change from having no activity in FYs 2017 and 2018. The objective of this audit was to determine whether local purchases and payments made at the Dickinson MPO were valid, properly supported and processed.

The Social Security Act requires that each Medicare administrative contractor (MAC) have its information security program evaluated annually by an independent entity. The Centers for Medicare & Medicaid Services (CMS) contracted with Guidehouse, LLP (Guidehouse), to evaluate information security programs at the MACs, using a set of agreed-upon procedures (AUPs). HHS OIG must submit to Congress annual reports on the results of these evaluations, to include assessments of their scope and sufficiency. This report fulfills that responsibility for fiscal year 2018.

This report presents the results of our self-initiated audit of Postage Refunds – North Topeka, KS, Post Office. OIG data analytics identified that the North Topeka Post Office issued postage refunds exceeding $38,000 from January 1 through March 31, 2019, for Account Identifier Code (AIC) 528, Refund of Permit Postage and Fees. The refunds represented 84 percent of total AIC 528 refunds issued during this period in the Central Plains District. The objective of this audit was to determine whether refunds for postage were valid, properly supported, and processed at the North Topeka Post Office.

The Child Care and Development Block Grant Act of 2014 (CCDBG Act) added new requirements for States receiving Child Care and Development Fund (CCDF) money to conduct comprehensive criminal background checks on staff members and prospective staff members of childcare providers every 5 years. States must have requirements, policies, and procedures in place to conduct criminal background checks for staff members of childcare providers (other than relatives) that are licensed, regulated, or registered under State law or receive CCDF funds. Background check requirements apply to any staff member who is employed by a childcare provider for compensation or whose activities involve the care or supervision of children or unsupervised access to children.

OIG administers Medicaid Fraud Control Unit (MFCU) grant awards, annually recertifies each MFCU, and oversees MFCU performance in accordance with the requirements of the grant. As part of this oversight, OIG conducts periodic reviews of MFCUs and prepares public reports. These onsite reviews supplement OIG's annual recertifications of the MFCUs. The primary purpose of this onsite review was to identify and address factors that contributed to the Utah MFCU's low number of fraud convictions during fiscal years (FYs) 2015-2017 and declining amounts of nonglobal* civil settlements, judgments, and recoveries in FY 2017.

The Office of the Inspector General conducted a review of the Hydro Generation, North Eastern Region (Hydro NE) to identify operational and cultural strengths and risks that could impact Hydro NE’s organizational effectiveness. Our report identified strengths within Hydro NE related to (1) organizational alignment, (2) positive interactions within and outside of Hydro NE, (3) first-line leadership, and (4) positive ethical culture. However, we also identified risks that could impact Hydro NE’s ability to meet its responsibilities in support of Power Operations’ mission. These included risks related to perceptions of (1) inadequate staffing and (2) lack of accountability.

This Comprehensive Healthcare Inspection Program (CHIP) provides a focused evaluation of the quality of care delivered at the Central California VA Health Care System (the facility), which covers leadership, organizational risks, and key processes associated with promoting quality care. Focus areas were Quality, Safety, and Value; Medical Staff Privileging; Environment of Care; Medication Management: Controlled Substances Inspections; Mental Health: Military Sexual Trauma Follow-Up and Staff Training; Geriatric Care: Antidepressant Use among the Elderly; Women’s Health: Abnormal Cervical Pathology Results Notification and Follow-Up; and High-Risk Processes: Emergency Department and Urgent Care Center Operations. At the time of the OIG’s on-site visit, the facility’s executive leadership team appeared relatively stable with three positions permanently filled for over two years and one position vacant for approximately one month. For selected employee survey scores, the OIG noted that employees appeared generally satisfied. However, opportunities appeared to exist to improve inpatient and Patient-Centered Medical Home outpatient experiences. Review of the facility’s accreditation findings, sentinel events, disclosures, and patient safety indicator data did not identify any substantial organizational risk factors. The leadership team was knowledgeable within their scope of responsibility about selected Strategic Analytics for Improvement and Learning (SAIL) and community living center (CLC) metrics but should continue to take actions to improve performance of measures contributing to the SAIL “2-star” and CLC “3-star” quality ratings. The OIG issued 11 recommendations for improvement in the following areas: (1) Quality, Safety, and Value • Interdisciplinary review of utilization management data (2) Medical Staff Privileging • Focused and ongoing professional practice evaluation processes (3) Environment of Care • Medication safety • Mental health unit panic alarm testing response time documentation (4) Controlled Substances Inspections • Inventory balance adjustment processes (5) Military Sexual Trauma (MST) Follow-up and Staff Training • Providers’ training (6) Emergency Departments and Urgent Care Center Operations • Backup call schedule