Federal Reports

We investigated an allegation that an official at the Southern Campaign Parks Group (SOCA), National Park Service (NPS), an artist, and a park friends group conspired to set up the purchase of one of the artist’s paintings via a 2015 transaction with the friends group so that the artist could avoid a Federal tax garnishment. We also investigated the timing of the art purchase that seemed to coincide with a funding increase in the cooperative agreement between the friends group and Kings Mountain National Military Park (KIMO), a park within SOCA.We found that the SOCA official directed the NPS’ acquisition of a $39,000 painting by the artist in 2015 and structured the purchase using the friends’ group as a broker for the sale even though the friends’ group did not own the painting. This structure allowed the artist, the painting’s true owner, to avoid a Federal tax garnishment that would have been imposed on him had he sold the painting directly to the NPS. The SOCA official admitted to coordinating the transaction with both the artist and the friends group, which included dictating that the friends group receive a $4,000 fee for its role in the transaction.In addition, we found that NPS contracting officials and KIMO staff did not follow Federal regulations and U.S. Department of the Interior procurement policies during the acquisition of the painting; specifically, the NPS and KIMO should have purchased the painting through a competitive bidding process rather than using sole source procedures.We also found that KIMO increased the annual funding to the friends group’s cooperative agreement by $25,000 around the same time the SOCA official began coordinating the purchase of the painting, but we found no direct connection between the friends group’s role in acquiring the painting and the increase in funding. We did find, however, that KIMO staff improperly extended the period of performance of the cooperative agreement without authorization from contracting officials.The U.S. Attorney’s Office for the District of South Carolina declined prosecution. We provided this report to the NPS Deputy Director Exercising the Authority of Director.

This audit report is one of a series of OIG reports that addresses the identification, reporting, and investigation of incidents of potential abuse and neglect of our Nation's vulnerable populations, including the elderly and individuals with developmental disabilities. OIG is committed to detecting and combating such abuse and neglect. Accordingly, we prepared this audit report after identifying a significant number of Medicare claims submitted for the treatment of injuries related to potential abuse and neglect.

This audit report is one of a series of OIG reports addressing the identification, reporting, and investigation of incidents of potential abuse and neglect of our Nation's most vulnerable populations, including the elderly and individuals with developmental disabilities. Our objectives were to determine (1) the prevalence of incidents of potential abuse or neglect of Medicare beneficiaries residing in skilled nursing facilities (SNFs) who had a hospital emergency room (ER) Medicare claim in calendar year 2016 containing a high-risk diagnosis code, (2) whether these incidents of potential abuse or neglect were properly reported by the SNFs, (3) whether the Centers for Medicare & Medicaid Services (CMS) and State Survey Agencies (Survey Agencies) reported findings of substantiated abuse to local law enforcement, and (4) the extent to which CMS requires incidents of potential abuse or neglect to be recorded and tracked.

From January 1, 2014, through December 31, 2015, Medicare administrative contractors (MACs) nation-wide paid freestanding facilities, facilities affiliated with hospitals, and physicians (collectively referred to as "providers") approximately $800 million for selected polysomnography (a type of sleep study to diagnose and evaluate sleep disorders) services. Previous OIG reviews for polysomnography services found that Medicare paid for services that did not meet Medicare requirements. These reviews identified payments for services with inappropriate diagnosis codes, without the required supporting documentation, and to providers that exhibited patterns of questionable billing.

To determine whether the Social Security Administration (SSA) properly used Medical Improvement Review Standard (MIRS) exceptions, other than failure to cooperate, during continuing disability reviews (CDR) conducted in Calendar Year 2017.

To determine whether the Social Security Administration (SSA) complied with its policies when it paid benefits to minor children.

To determine whether the Social Security Administration (SSA) identified and properly resolved underpayments on prior Supplemental Security Income (SSI) records.