Federal Reports

For our audit period (January 1, 2015, through December 31, 2017), Medicare should not have paid suppliers for any of the $34 million for durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) that were provided during inpatient stays. In addition, beneficiaries were held responsible for unnecessary deductibles and coinsurance of $8.7 million paid to the suppliers for the DMEPOS items. Generally, Medicare should not pay a supplier for these items provided to a beneficiary during an inpatient stay. Instead, all items must be provided directly by the inpatient facility or under arrangements between the facility and the supplier. Medicare should pay the inpatient facility, through its inpatient claim, for all items provided to a beneficiary.

The OIG investigated allegations that two former employees of a tribally controlled school funded by the Bureau of Indian Education (BIE) did not repay payroll advances.We found that one employee failed to repay the school for more than $77,000 in payroll advances and the other failed to repay the school for more than $16,000 in payroll advances. Both employees admitted to owing the funds and that they made no attempt to repay the money when they were no longer employed by the school.We referred this matter to the U.S. Attorney’s Office for the District of New Mexico, which declined prosecution.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements

The memorandum was issued in response to two significant vulnerabilities identified by OIG during a site visit to the influx care facility in Tornillo, Texas (Tornillo), a grantee of the Unaccompanied Alien Children (UAC) Program operated by the Office of Refugee Resettlement (ORR). Specifically, OIG found that Tornillo is not conducting required Federal Bureau of Investigation (FBI) fingerprint background checks for staff working at Tornillo, instead using checks conducted by a private contractor that has access to less comprehensive data. Secondly, OIG found that Tornillo does not employ a sufficient number of staff clinicians to provide adequate mental health care for UAC. Both issues warrant immediate attention because they pose substantial risks to children receiving care at this facility.

The VA Office of Inspector General (OIG) conducted a healthcare inspection regarding allegations of patient and radiation safety concerns at the John D. Dingell VA Medical Center, Detroit, Michigan. To reduce the risk of unnecessary radiation exposure, the Veterans Health Administration (VHA) requires that radiology staff ensure equipment is operating properly, follow appropriate procedures, use shielding and engineered safety features, and ensure radiation doses are as low as reasonably achievable. The OIG substantiated annual radiologic equipment inspections were not performed for most of fiscal years 2015 through 2017, although inspections were current as of April 5, 2018. The OIG substantiated that a radiologist performed fluoroscopy procedures without having current training or privileging and the radiology department did not conform to VHA radiation safety standards. The OIG substantiated that the Chief of Radiology changed the Radiology privileging form; however, the OIG did not substantiate that the form was changed to request and grant authorized user status. Although the OIG substantiated that facility staff were not permitted to perform nuclear medicine studies because the Master Materials License permit was revoked in 2009, it was reinstated in 2010. During the inspection, facility leaders identified portions of the radiation safety program that were not completed in a consistent and timely manner, including deficient equipment testing, lack of lead aprons and shields annual inspections, and dosimeter badges processing. The OIG also identified issues with the nuclear medicine waiting room dosimeter, radiology technicians’ training records, and a tracking matrix. Although the OIG found deficiencies in the Facility’s radiation safety program and made recommendations, the OIG did not identify deficiencies that put patients and staff at immediate risk or warranted stopping patient care. The OIG made six recommendations related to equipment testing, fluoroscopy training, clinical privileges, radiation safety, and tracking and monitoring corrective actions to completion.