Federal Reports

Under the Medicare home health prospective payment system (PPS), the Centers for Medicare & Medicaid Services pays home health agencies (HHAs) a standardized payment for each 60-day episode of care that a beneficiary receives. The PPS payment covers intermittent skilled nursing and home health aide visits, therapy (physical, occupational, and speech-language pathology), medical social services, and medical supplies.

Previous OIG reviews found that States had improperly paid Medicaid Managed Care Organizations (MCOs) capitation payments on behalf of deceased beneficiaries. We conducted a similar review of the Illinois Department of Healthcare and Family Services, which administers the Medicaid program. Our objective was to determine whether Illinois made capitation payments on behalf of deceased beneficiaries.

The VA Office of Inspector General (OIG) conducted this audit to determine whether the Office of Information and Technology and the Veterans Health Administration (VHA) effectively managed the implementation of VA’s Veterans Information Systems and Technology Architecture (VistA) Scheduling Enhancement (VSE) project. VA has struggled for almost two decades to replace its cumbersome and outdated medical appointment scheduling system. VSE was launched in May 2014 and was intended to be an interim solution to VA’s medical appointment scheduling problem. The OIG found the VSE project management team did not effectively manage the project to ensure scheduling enhancements were adequately developed and met users’ needs. The audit team determined that the approved specifications were insufficient to ensure the scheduling enhancements would meet VHA’s needs. According to VHA’s information technology project manager, the Office of Information and Technology approved the release of a version of VSE in April 2017. However, the OIG audit team found delays in deployment persisted until the final contract modification for VSE ended in September 2017. VA has since decided to use a standalone scheduling component within the electronic health records system being developed under contract by the Cerner Corporation as a permanent solution. The first standalone scheduling component is planned for deployment in 2020, according to a December 2018 report to Congress. The OIG recommended the assistant secretary for Information and Technology enforce current required project management processes with improved oversight to ensure project planning requirements are adequately defined and supported before starting information technology projects.

The U.S. Postal Service uses contracted delivery suppliers to support mail delivery needs and ensure it meets its universal service obligation. CDS is a contractual agreement between the Postal Service and an individual or company for the delivery and collection of mail for customers. CDS is considered one of the Postal Service’s three primary carrier delivery types (city and rural carriers, and contracted delivery suppliers). CDS suppliers1 are not Postal Service employees, but independent contractors who provide delivery service on specific routes not serviced by city or rural carriers. The objective of our audit was to assess the effectiveness of controls over CDS and its costs.

The U.S. Department of Health and Human Services (HHS), Food and Drug Administration (FDA), did not submit an Office of Inspector General (OIG) clearance document for any of the 166 audit recommendations, which were identified in OIG stewardship reports, during Federal fiscal years (FYs) 2015 and 2016. As a result, all of the recommendations were outstanding, and listed on the stewardship report as past due for resolution, as of September 30, 2016. However, for 134 of the 166 recommendations (from 7 information technology audit reports), FDA did address the audit recommendations in detail, to include statements of corrective actions, in its comments on those reports. These 166 past-due recommendations were procedural in nature; none of them involved dollar amounts such as recommended disallowances.