Federal Reports

New York improperly claimed reimbursement for 36 of 100 payments made to Medicaid Managed Long-Term Care (MLTC) plans. Specifically, New York did not ensure that MLTC plans documented eligibility assessments of program applicants and reassessments of those already in the program, and conducted these assessments in a timely manner. New York also did not ensure that the plans provided services to beneficiaries according to a written care plan. Further, New York did not ensure that the plans enrolled and retained only those beneficiaries who required community-based services, and disenrolled beneficiaries who requested disenrollment in a timely manner.

The Wisconsin Department of Children and Families (DCF) did not always comply with Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program requirements and the terms and conditions of the program's grants, resulting in unallowable expenditures totaling $275,175. Specifically, for the five subrecipients reviewed, DCF did not ensure that one subrecipient used grant funding for allowable purposes. We also found that for three of the five subrecipients, DCF did not ensure that subrecipients' time-and-effort reporting systems complied with Federal requirements. In addition, DCF did not have adequate procedures to monitor subrecipients, could not provide an approved budget for one of its subrecipient agreements, and did not comply with Federal Funding Accountability and Transparency Act of 2006 (FFATA) reporting requirements. We did not identify any unallowable expenditures at the State level.

In April 2017, we evaluated the San Juan VA Regional Office (VARO) to assess timeliness and accuracy of claims processing, rating reductions, systems compliance and specially controlled correspondence. We found Veterans Service Center (VSC) staff did not consistently process one of the two types of disability claims reviewed. We reviewed 30 veterans’ traumatic brain injury (TBI) claims and found all were accurately processed. OIG reviewed 23 special monthly compensation (SMC) claims and found four claim inaccurately processed. The errors occurred because second signature reviews were ineffective. Overall, VSC staff accurately processed 49 of the 53 veterans’ disability cases. These cases included improper payments totaling approximately $4,900. VSC staff generally processed proposed rating reductions accurately but needed better oversight to ensure claims are completed at the expiration of the due process period. OIG reviewed all 16 benefits reduction cases and found processing delays in four cases resulting in overpayments of approximately $12,300. VSC staff entered inaccurate or incomplete claim and claimant information into the electronic systems in 19 of 30 claims reviewed. In general, these errors occurred because employees were inexperienced and lacked training related to the proper procedures for establishing claims while adhering to systems compliance requirements. VSC staff accurately, but slowly processed the single inquiry requiring special control received between December 1, 2016 and February 28, 2017. It took VSC staff 59 days to provide the final response. We also found staff did not input the correct received date for the inquiry we reviewed. We recommended the VARO Director develop and implement a plan to ensure secondary reviewers accurately evaluate higher-level SMC and ancillary benefits claims, implement a plan to ensure all claims processing staff receive additional training on claims establishment procedures, and monitor the effectiveness of that training. The VARO Director concurred with our recommendations. Management’s planned actions are responsive and we will follow up as required.

Post office foot traffic varies widely. The 450 largest locations have on average about as much foot traffic as Best Buy stores, while the next 7,000 largest have about as much traffic as CVS locations. An OIG survey shows that Millennials visit post offices more often than older generations, but for different purposes. Following on the footsteps of the retail sector, USPS could use proven foot traffic measurement solutions to make better retail decisions and improve customer services and sales.

At the request of the Tennessee Valley Authority's (TVA) Supply Chain, we examined the cost proposal submitted by a company for civil projects and coal combustion residual program management work at TVA's steam electric power plants. Our examination objective was to determine if the company's cost proposal was fairly stated for a planned <br> $100 million contract.In our opinion, the company's cost proposal was overstated as follows:The company's proposal for a Cumberland Fossil Plant project included overstated (1) equipment costs, (2) overhead markup rates, and (3) material costs. In addition, the company's proposed fee rate exceeded the maximum allowable fee rate in TVA's request for proposal (RFP).Proposed time and material (T&M) rates were not supported by the company's actual costs.The company did not comply with the RFP requirements regarding cost reimbursable work.We estimated TVA could avoid about $11.1 million on the planned $100 million contract by (1) negotiating the appropriate reductions to the company's proposed equipment costs, material costs, and overhead rate, and (2) limiting the company's fee rate to the RFP's maximum allowable rate. In addition, we suggest TVA negotiate revisions to the company's T&M rates to more accurately reflect its actual costs and require compliance with the RFP's cost reimbursable provisions.(Summary Only)

HHS oversees States' use of various Federal programs, including Medicaid. State agencies are required to establish appropriate computer system security requirements and conduct biennial reviews of computer system security used in the administration of State plans for Medicaid and other Federal entitlement benefits (45 CFR § 95.621). This review is one of a number of HHS OIG reviews of States' computer systems used to administer HHS-funded programs. Our objective was to determine whether Alabama adequately secured its Medicaid data and information systems in accordance with Federal requirements.