Federal Reports

For a covered outpatient drug to be eligible for Federal Medicaid reimbursement, the manufacturer must enter into a rebate agreement administered by the Centers for Medicare & Medicaid Services (CMS) and pay quarterly rebates to the States. Previous OIG reviews found that States did not always bill and collect all rebates due for drugs administered by physicians to enrollees of Medicaid managed-care organizations (MCOs).

The VA Office of Inspector General (OIG) performed this audit to determine if Veterans Health Administration (VHA) medical facilities are scanning and entering medical documentation into patients’ records accurately and in a timely manner. VHA healthcare staff rely on medical records to manage veterans’ care. Incorporating records into patients’ electronic health records is critical because it ensures complete, accurate, and readily accessible health information to guide clinicians’ decisions. The OIG found limited VHA monitoring and oversight created backlogs that put the continuity of patient care at risk. Based on provided data, the audit team calculated that VHA medical facilities have a cumulative medical document backlog of approximately 5.15 miles of stacked paper and at least 597,000 individual electronic document files dating back to October 2016. This occurred because staff did not scan documents and enter them into the electronic medical records in a timely manner. Staff also did not always perform appropriate reviews and monitoring to assess the overall quality and legibility of scanned documents. The OIG also found staffing shortages contributed to the backlogs. The audit team documented that officials at seven of eight medical facilities visited did not ensure compliance with mandatory quality assurance reviews to identify and correct any errors before medical documents were shredded. Officials at the eight facilities also did not meet training requirements or consistently follow training policy. The OIG made nine recommendations for VHA to define and promptly reduce backlogs; account for scanning demand in staffing decisions; and develop monitoring roles, controls, and procedures.

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This report presents the results of our self-initiated audit of Miscellaneous Non-Postal Revenue Refunds – South Hackensack, NJ, Annex. The South Hackensack Annex is in the Northern New Jersey District of the Northeast Area. This audit was designed to provide Postal Service management with timely information on potential financial control risks at Postal Service locations. The objective of this audit was to determine whether refunds for miscellaneous non-postal revenue were valid and properly supported at the South Hackensack, NJ Annex.

Background checks are an important safety measure that can help protect the 9 million beneficiaries who rely on long-term-care services each year for safe, dependable care. These checks can prevent individuals with disqualifying histories (e.g., convictions for patient abuse, patient neglect, and theft from patients) from being hired to care for beneficiaries. The National Background Check Program (Program) provides grants to States to develop systems to conduct background checks of State and Federal criminal history records for prospective long-term-care employees.

OIG data analytics identified the W.T. Harris Station as having $78,368 in meter revenue refunds from January 1 through March 31, 2019, compared to $48,973 for the prior quarter (October 1 through December 31, 2018), which is a 60 percent increase based on data from the Enterprise Data Warehouse (EDW). Spoiled or unused customer meter stamp refunds for the W.T. Harris Station were 85 percent of the overall amount of the meter stamp refunds in the Mid-Carolinas District for the same timeframe. This percentage ranked the highest in the Mid-Carolinas District and the second highest in the nation. The objective of this audit was to determine whether meter refunds were properly issued, supported, and processed.

Based on our data analysis, miscellaneous services at the Sturgeon Bay Post Office totaled $4,325 for fiscal year (FY) 2019, Quarter (Q) 2, which is a significant change from having no activity for FY 2018, Q2. In addition, miscellaneous services for FY 2019, Q2, at the Sturgeon Bay Post Office were the highest for the Lakeland District, or 48 percent of the district’s total of $9,022. It is unusual for one office to have such a high percentage as it relates to other offices in the same district. Our objective was to determine whether local purchases and payments made at the Sturgeon Bay Post Office for miscellaneous services were valid, properly supported, and processed.

In accordance with our annual plan, the Office of Inspector General (OIG) conducted a survey of the United States Capitol Police (USCP or Department) Continuity of Operations (COOP) Program. Our primary objectives were to gain a better understanding of the USCP COOP Program and identify any areas suited for future detailed evaluations, inspections, or audits. Our scope included existing policies and procedures related to the USCP COOP Program.