Federal Reports

Due to the importance of the clearance procedure to plant personnel safety, and in response to recent fatalities resulting from clearance violations, we initiated a review of TVA’s coal operations’ clearance procedure. We determined the clearance procedure was being performed for work requiring clearances. However, the effectiveness of the clearance process is limited because (1) some clearances were not in compliance with the clearance procedure, (2) required training had not been completed by all personnel holding or working on clearances, and (3) audits performed were not in compliance with the procedure. We also identified opportunities for improvement related to procedure clarification and training.

Our objective was to evaluate U.S. Postal Service controls for assessing postage on underpaid packages entered using the Electronic Verification System (eVS). The Postal Service provides several ways for commercial parcel mailers (commercial mailers) to print postage and transmit shipping and payment information to the Postal Service. One option is the eVS, which allows commercial mailers to print postage labels and electronically transmit manifests with detailed shipping and payment information to the Postal Service. Other options include Click-N-Ship for Business, Permit Imprint, and PC Postage. Mailers choose the option that best fits their business needs.

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A central concern about the capitated payment model used in Medicare Advantage is the potential incentive for MAOs to inappropriately deny access to services and payment in an attempt to increase their profits. An MAO that inappropriately denies authorization of services for beneficiaries, or payments to health care providers, may contribute to physical or financial harm and also misuses Medicare Program dollars that CMS paid for beneficiary healthcare. Because Medicare Advantage covers so many beneficiaries (more than 20 million in 2018), even low rates of inappropriately denied services or payment can create significant problems for many Medicare beneficiaries and their providers.