Federal Reports

We found that the California Department of Rehabilitation did not have adequate data quality controls to ensure that information it reported to Rehabilitation Services Administration (RSA) was accurate, complete, and adequately supported. Specific control weaknesses we identified were (1) lack of an adequate control to prevent staff from changing the date that a participant’s case was closed in its case management system; (2) insufficient requirements that personnel maintain documentation to corroborate key dates for application, eligibility, case closure, and employment data; (3) lack of guidance for determining effective dates for participants’ plans; and (4) insufficient manager oversight to provide assurances that data were accurate and required documentation was maintained. Our testing of data that California Department of Rehabilitation reported to RSA showed that most of the data elements in our review contained significant data errors that could undermine RSA’s ability to effectively evaluate the California Department of Rehabilitation’s performance or a significant unverifiable data rate that would raise questions about the reliability of data that it reported.

ARC approved the grant funding to support a project to upgrade the water and sewer system in Wilkesboro.

ARC awarded the grant to the SC Department of Commerce (DOC) who was responsible for administering the grant under the SC State Basic Agency Administrative Procedures for ARC construction projects.

Englewood Hospital and Medical Center (the Hospital) (operating in New Jersey) claimed Medicare reimbursement for outpatient cardiac and pulmonary rehabilitation services that did not comply with Medicare reimbursement requirements. For 46 of the 100 claims in our random sample, the Hospital improperly claimed Medicare reimbursement. On the basis of our sample results, we estimated that the Hospital improperly received at least $115,000 in Medicare reimbursement for services that did not comply with Medicare requirements. We recommended that the Hospital (1) refund $115,000 to the Federal Government and (2) implement written policies and procedures to ensure that outpatient cardiac and pulmonary rehabilitation services are provided and documented in accordance with Medicare requirements.

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