Federal Reports

The OIG and the FBI jointly investigated allegations that two employees stole school funds from the Shonto Preparatory School (SPS) in Arizona, which is funded by grants from the Bureau of Indian Education.The investigation determined that former SPS Business Manager Felicia Barlow stole $20,430.87 by fraudulently obtaining three SPS checks. Barlow pled guilty to one count in violation of 18 U.S.C. § 1163, Embezzlement and theft from Indian tribal organizations, in U.S. District Court for the District of Arizona, and was sentenced to 2 years of probation and ordered to pay $20,430.87 in restitution. A second SPS employee was not charged.

Oklahoma did not follow its policies and procedures to ensure there was evidence in Title IV-E case files to support that all required health care services were provided to Title IV-E children in foster care. Nor were there Medicaid claims in the State's Medicaid Management Information System to support that all of the children whose case files lacked documentation received the required services.

The objective of this audit is to determine whether internal controls for issuing refunds for walk-in revenue were in place and effective at the Kissimmee, FL, Main Office. The OIG Field Financial Risk Model identified the Kissimmee Main Office, for quarters (Q) 3 and 4 fiscal year 2017, made over 50 percent of all walk-in revenue refunds within the Suncoast District. Additionally, the Kissimmee Main Office refunded about 38 to 56 percent of the total walk-in revenue during Q’s 3 and 4. The audit team reviewed 50 refund transactions, totaling $255,211 or 99.4 percent of the total refund amount identified, between April 1 and September 30, 2017.

Arkansas did not always comply with Federal Medicaid requirements for invoicing manufacturers for rebates for physician-administered drugs. Arkansas did not invoice manufacturers for rebates associated with $9.9 million (Federal share) in physician-administered drugs. Of this amount, $8.5 million was for single-source drugs, and $1.4 million was for top-20 multiple-source drugs. Because Arkansas' internal controls did not always ensure that it invoiced manufacturers to secure rebates, Arkansas improperly claimed Federal reimbursement for these single-source drugs and top-20 multiple-source drugs.

This portfolio presents an overview of program vulnerabilities identified in prior Office of Inspector General audits, evaluations, investigations, and legal actions related to chiropractic services in the Medicare program. It consolidates the findings and issues identified in that work and discusses recommendations from prior reports that have not been implemented or have been implemented ineffectively. In addition, this portfolio provides information to help the Centers for Medicare & Medicaid Services understand the need for effective controls over chiropractic services and offers recommendations to help Medicare prevent fraud, waste, and abuse related to those services.