Federal Reports

The Office of Inspector General assessed NASA’s progress in improving its information technology governance and security over the past 4 years.

OIG conducted a healthcare inspection in response to allegations made by a confidential complainant in 2015 regarding the Opioid Agonist Treatment Program (OATP) at the Baltimore VA Medical Center, one of three VA Maryland Health Care System campuses, located in Baltimore, MD. The complainant alleged the OATP lacked quality controls necessary to ensure patients received treatment planning and monthly counseling as required, which resulted in patient deaths. We substantiated that the OATP lacked effective quality controls necessary to ensure patients consistently received required treatment planning and monthly counseling. We determined the failure to provide consistent treatment planning and monthly counseling was due, in part, to a lack of counseling staff supervision. We did not substantiate that OATP patients died as a result. We also determined the OATP lacked a clear policy on cardiac risk management and quality controls to ensure appropriate cardiac monitoring. We identified a concern related to the role of the OATP Medical Director. 42 CFR § 8.12 (b) and the Substance Abuse and Mental Health Services Administration require that the medical director be responsible for ensuring regulatory compliance with all applicable Federal, State, and local laws and regulations. However, the OATP policy describing the medical director’s duties did not include regulatory compliance responsibility or define a sufficient number of hours to ensure regulatory compliance.

An anonymous complainant alleged Center for Family Services (CFS), Camden, NJ, directed AmeriCorps members (member) to displace paid staff. In addition, members were submitting fraudulent timesheets. The CNCS-OIG investigation found that CFS violated (1) the CFS AmeriCorps grant when they assigned members to perform service outside the scope of the grant, (2) 45 CFR § 2540.100 (e) when they required members as part of their service to perform activities substantially similar to those already performed by an employee (teacher/assistant teacher), and (3) 45 CFR § 2521.45 when they failed to comply with match requirements. In addition, two former members violated 18 USC § 1001 when they knowingly submitted fraudulent timesheets.

For the 30 grants we reviewed, HRSA awarded Zika Act funds during fiscal year 2017 in compliance with applicable Federal and HHS grant policies. Accordingly, this report contains no recommendations.

The Patient Protection and Affordable Care Act established the Medicare Shared Savings Program (MSSP) to facilitate coordination and cooperation among providers and suppliers to (1) improve quality of care for Medicare fee-for-service beneficiaries and (2) reduce health care costs. Eligible providers and suppliers may voluntarily participate in the MSSP by creating or joining an accountable care organization (ACO). Beneficiary assignment is the basis for many key MSSP operations, such as determining an ACO's financial performance and reporting quality measures after each performance year (PY). The designated ACO is responsible for the quality and cost of care of its assigned Medicare beneficiaries during a PY. ACOs may be eligible to receive additional payments (i.e., shared savings payments) if they reduce health care costs and meet certain quality performance standards. ACOs may also be responsible for a portion of any shared losses.

Our objective was to assess the accuracy and reliability of In-Office Cost System (IOCS) telephone readings. The IOCS is the primary probability sampling system used by the U.S. Postal Service to attribute the labor costs of clerks, mail handlers, city carriers, and supervisors related to the handling of mail of all classes and rate categories. While the DCTs observed by the OIG during selected site visits generally followed policies and procedures, opportunities exist to improve sampling procedures and controls to enhance the accuracy and reliability of the data.