Federal Reports

The HHS OIG's reviews of information system general controls at two Medicaid managed care organizations (MCOs) in Arizona identified numerous security vulnerabilities. The Arizona Health Care Cost Containment System administers Arizona's Medicaid program and is the State agency responsible for monitoring the operations of its contracted MCOs. The MCOs' systems depend on the effectiveness of information system general controls, which are critical to the confidentiality, integrity, and availability of Medicaid data.

New York may have improperly claimed reimbursement for 7,650 dental services totaling $1.3 million ($670,000 Federal share). Of these, 712 claims, totaling $66,000 ($34,000 Federal share), were for Medicaid fee-for-service dental services and 6,938 claims, totaling $1.3 million ($635,000 Federal share), were for clinic dental services.

This report presents the results of our self-initiated audit to evaluate mail delivery issues on selected routes at the San Antonio – Heritage Station. The Heritage Station is in the Rio Grande District of the Southern Area. We conducted the audit to provide U.S. Postal Service management with timely information on potential operational risks at the Heritage Station.

This report presents the results of our self-initiated audit of No Sale Transactions – Dallas, TX, Mockingbird Finance Station. The Mockingbird Finance Station is in the Dallas District of the Southern Area. This audit was designed to provide U.S. Postal Service management with timely information on potential financial control risks at Postal Service locations.

We observed significant vulnerabilities in the wage index system while conducting 41 reviews of hospitals' wage data, with reports issued from 2004 through 2017. CMS uses area wage indexes to adjust hospital payments annually to reflect local labor prices. CMS calculates each area's wage index based on wage data submitted by acute-care hospitals in their Medicare cost reports. Medicare administrative contractors (MACs) perform limited reviews of these data. Federal law requires that the area wage indexes applied to urban hospitals in a State cannot be lower than the wage index for the rural hospitals in that State. This provision is called the "rural floor." Federal law allows some hospitals to reclassify to areas with higher wage indexes to receive higher payments. "Hold-harmless" provisions in Federal law and CMS policy protect hospitals from having their wage indexes lowered because of the geographic reclassification of other hospitals.

The Postal Service reports mail processing delays when mail is not processed in time to meet its established delivery or when mail is processed but not on the dock in time for scheduled transportation to delivery units. From October 2017 through June 2018, there were over 106 million mailpieces reported as mail processing delays at the Denver P&DC, a 57 million mailpiece (53 percent) increase from the amount reported in fiscal year (FY) 2017. The objective of our audit was to determine the cause of mail processing delays reported at the Denver, CO, Processing and Distribution Center (P&DC).

We investigated whether the boundaries of Utah’s Grand Staircase-Escalante National Monument (GSENM) were modified, at least in part, for the personal financial benefit of former Utah State Representative Michael Noel, who owned property along the GSENM border and who is currently the executive director of the Kane County (UT) Water Conservancy District. Our investigation focused on:1. Whether the U.S. Department of the Interior (DOI) followed an established process for assessing proposed boundaries for national monuments, including the proposed GSENM boundary modifications2. Whether Noel influenced the boundary-modification proposal Interior Secretary Ryan Zinke submitted to the President, including whether Zinke was aware of Noel’s property ownership and financial interest in revising the GSENM boundaries and whether he gave Noel preferential treatment in the proposed boundariesWe found that although the DOI had no formal processes in place for modifying national monument boundaries, DOI staff developed and followed a consistent process when reviewing the GSENM and other DOI-controlled national monuments that were being considered for boundary modifications.We also found no evidence that Noel influenced the DOI’s proposed revisions to the GSENM boundaries, that Zinke or other DOI staff involved in the project were aware of Noel’s financial interest in the revised boundaries, or that they gave Noel any preferential treatment in the boundaries proposed to the President.We provided this report to the Deputy Secretary of the Interior for any action deemed appropriate.