We recommend that the Centers for Medicare & Medicaid Services work with the MACs to recover $35,560 in improper payments made to providers for the 128 sampled enrollee days that did not meet Medicare requirements.

23-A-09-068.02 - Closed

We recommend that the Centers for Medicare & Medicaid Services work with the MACs to based upon the results of this audit, notify appropriate providers (i.e., those for whom CMS determines this audit constitutes credible information of potential overpayments) so that the providers can exercise reasonable diligence to identify, report, and return any overpayments in accordance with the 60-day rule and identify any of those returned overpayments as having been made in accordance with this recommendation.

23-A-09-068.03 - Open

Now that CMS has reinstituted most program integrity measures, we also recommend that CMS take the following steps, which if in effect during the audit period could have saved Medicare an estimated $579,667,510 during that period: Conduct medical reviews of psychotherapy services, including services provided via telehealth, to verify that the services are documented and billed in accordance with Medicare requirements.

23-A-09-068.04 - Open

Now that CMS has reinstituted most program integrity measures, we also recommend that CMS take the following steps, which if in effect during the audit period could have saved Medicare an estimated $579,667,510 during that period: Implement system edits for psychotherapy services, including services provided via telehealth, to prevent payments for services that were billed incorrectly.

23-A-09-068.05 - Open

Now that CMS has reinstituted most program integrity measures, we also recommend that CMS take the following steps, which if in effect during the audit period could have saved Medicare an estimated $579,667,510 during that period: Strengthen educational efforts to make providers aware of educational materials on how to meet Medicare requirements and guidance for psychotherapy services, including services provided via telehealth.

23-A-09-068.06 - Open

Now that CMS has reinstituted most program integrity measures, we also recommend that CMS work with the MACs to take the following steps, which if in effect during the audit period could have saved Medicare an estimated $579,667,510 during that period: Review MAC jurisdictions' LCD requirements for psychotherapy services to identify which provisions effectively promote program integrity, and consider additional steps that CMS could undertake to ensure appropriate coverage and payment for psychotherapy services across all jurisdictions.

Department of Education OIG

University of Cincinnati’s Use of Higher Education Emergency Relief Fund Student Aid and Institutional Grants

Our objective was to determine whether the University of Cincinnati (University) used the Student Aid (Assistance Listing Number (ALN) 84.425E) and Institutional (ALN 84.425F) portions of its Higher Education Emergency Relief Fund (HEERF) funds for allowable and intended purposes. The University spent $109.9 million (83 percent) of its total HEERF allocation of $132.8 million as of September 30, 2021. The University generally used the Student Aid ($42.1 million) and Institutional ($67.8 million) portions of its HEERF grant funds for allowable and intended purposes but needs to strengthen its...

Full Details: Oversight.gov Report Page

Audit | 1/17/2023

1.1 - Open

Require the University of Cincinnati to develop and implement a review process to prevent or detect payment errors when awarding emergency financial aid grants to students, including written policies and procedures detailing how the reviews shall be conducted and the results documented, in accordance with 2 C.F.R. section 200.303.

1.2 - Open

Require the University of Cincinnati to develop and implement written policies, procedures, and management review to ensure that its award determinations, eligibility criteria, and management decisions related to eligibility for its emergency financial aid grants to students are adequately documented and supported at the time award decisions are made, in accordance with 2 C.F.R. section 200.302(b)(3).

1.3 - Open

Require the University of Cincinnati to carefully document how its student aid eligibility criteria prioritized and continues to prioritize students with exceptional need throughout the HEERF grant performance period.

2.1 - Open

Require the University of Cincinnati to develop and implement written policies and procedures, including procedures that would identify and prevent improper revenue recognition and duplicate charges, to ensure that future calculations for charging lost revenue to its HEERF Institutional grant are reviewed for accuracy and consistency with its financial reporting policies and procedures.

2.2 - Open

Determine whether the University of Cincinnati implemented appropriate corrective actions to resolve the $797,965 in unsupported lost revenue costs it charged to its HEERF Institutional grant; and, if the corrective actions are inappropriate, require the University to either return the funds to the Department or reallocate the funds for allowable expenditures.

2.3 - Open

Determine whether the $1,916,041 that the University of Cincinnati charged to its HEERF Institutional grant for noncompetitive procurements was reasonable when compared to the costs of suitable alternatives; and, if the charges were inappropriate, require the University to either return the funds to the Department or reallocate the funds for allowable expenditures.

2.4 - Open

Require the University of Cincinnati to develop and implement written policies and procedures to ensure that procurements charged to its HEERF Institutional grant are in accordance with applicable Federal requirements; and it consistently follows its procurement policies and procedures, including maintaining sufficient documentation to support its rationale for noncompetitive procurements and the basis for and reasonableness of the contract price.

3.1 - Open

Require the University of Cincinnati to incorporate in its policies and procedures and implement the cash management requirements for minimizing the time between drawing down and disbursing Federal grant funds, and remitting interest earned in excess of $500 in accordance with 2 C.F.R. section 200.305(b).

3.2 - Open

Require the University of Cincinnati to remit $35,439 based on the TIP’s average rate of return, less no more than $320 ($500 minus the $180 already retained) for administrative expenses if applicable; and remit the actual amount of earned interest on any future advances of Federal funds, in accordance with 2 C.F.R. section 200.305(b)(9).

4.1 - Open

Require the University of Cincinnati to develop and implement written policies and procedures that incorporate the HEERF program’s reporting requirements and ensure that the expenditures in its quarterly HEERF Institutional expenditure reports are accurate and reported in the appropriate expenditure category.

Department of Health & Human Services OIG

Illinois Generally Complied With Requirements for Claiming Medicaid Reimbursement for Telehealth Payments During COVID-19

Full Details: Oversight.gov Report Page

Audit | 12/21/2022

Department of Health & Human Services OIG

IHS Did Not Always Provide the Necessary Resources and Assistance To Help Ensure That Tribal Programs Complied With All Requirements During Early COVID-19 Vaccination Program Implementation

Full Details: Oversight.gov Report Page

Audit | 10/17/2022

Department of Education OIG

Michigan’s Administration of the Governor’s Emergency Education Relief Fund

The objectives of the audit were to determine whether the State of Michigan (Michigan) designed and implemented awarding processes that ensured that the Governor’s Emergency Education Relief Fund (GEER grant) was used to support local educational agencies (LEAs) and institutions of higher education (IHEs) that were most significantly impacted by the coronavirus or LEAs, IHEs, or other education-related entities within the State that were deemed essential for carrying out emergency educational services; and monitoring processes to ensure that subgrantees used GEER grant funds in accordance with...

Full Details: Oversight.gov Report Page

Audit | 9/14/2022

Department of Education OIG

Oklahoma’s Administration of the Governor’s Emergency Education Relief Fund Grant

The objectives of the audit were to determine whether the State of Oklahoma (Oklahoma) designed and implemented awarding processes that ensured that the Governor's Emergency Education Relief Fund (GEER grant) was used to support local educational agencies (LEA) and institutions of higher education (IHE) that were most significantly impacted by the coronavirus or LEAs, IHEs, or other education-related entities within the State that were deemed essential for carrying out emergency educational services; and monitoring processes to ensure that subgrantees used GEER grant funds in accordance with...

Full Details: Oversight.gov Report Page

Audit | 7/18/2022

1.1 - Open

Provide documentation, or a full and detailed written explanation, of the process Oklahoma used to determine the initiatives it supported with GEER grant funds and the entities it selected to administer the initiatives.

1.2 - Open

Develop and implement a process to ensure that it documents the criteria and decisions made for awarding future GEER grant funds in accordance with applicable requirements.

1.3 - Open

Develop and implement internal controls to ensure that it administers current and future GEER grants in accordance with applicable Federal laws and grant requirements, including ensuring that grant subrecipients are provided the proper award documentation; and that any entity that is awarded Federal funds retains records relating to those awards in accordance with Federal requirements.

1.4 - Open

Perform a 100 percent review, or review a statistical sample, of the Stay in School Fund microgrant recipients to confirm that all students were eligible to receive GEER grant funds.

1.5 - Open

Develop and implement written policies and procedures to describe the specific circumstances under which deviations from procurement rules are warranted, including procedures about required documentation of such decisions for procurements that do not use competitive bidding but use Federal education funds.

1.6 - Open

Take appropriate action if the documentation and other information provided by Oklahoma in response to the above recommendations does not support that the State followed applicable requirements.

2.1 - Open

Return $652,720 to the Department for the unallowable Bridge the Gap expenditures we identified or provide documentation to support that the expenditures were allowable or the items were purchased with personal funds.

2.2 - Open

Perform a 100-percent review, or review a statistical sample, of the $5,473,894 in Bridge the Gap expenditures that we did not review to determine whether the expenditures were allowable, and if applicable, return the funds for any unallowable expenditures to the Department.

2.3 - Open

Develop and implement additional internal controls for the Skills to Rebuild, Learn Anywhere Oklahoma, Bridge the Gap, and Stay in School Fund initiatives that include written monitoring procedures for those processes that are already in place, and for additional procedures that include a review of expenditures and supporting documentation, and a review of documentation that supports the information in initiatives’ weekly status reports.

2.4 - Open

Develop and implement internal controls to ensure that fiscal agents for Federal grant programs obtain an understanding of the rules and regulations surrounding the grant programs they are tasked with overseeing.

3.1 - Open

Develop and implement controls to ensure that Oklahoma’s State agencies that receive Federal funds have written cash management policies and procedures, including policies for the draw down and disbursement of grant funds in accordance with Federal requirements.

3.2 - Open

Return to the Department any unexpended GEER grant funds applicable to our audit scope that are being held by GEER grant subrecipients.

3.3 - Open

3.4 - Open

Require its fiscal agent or State program representative to work closely with the Department to ensure that other GEER grants are administered in compliance with cash management rules and with any actions the Department determines are needed, if warranted.

Department of Health & Human Services OIG

An Estimated 91 Percent of Nursing Home Staff Nationwide Received the Required COVID-19 Vaccine Doses, and an Estimated 56 Percent of Staff Nationwide Received a Booster Dose

Full Details: Oversight.gov Report Page

Date Range

Report Type

Report Category

Submitting Agency

State/Local Agency

State (State and Local Reports)

Fraud Type

Agency Reviewed

Related Organizations

Management Challenges

Any Recommendations

Any Open Recommendations

Reports

Alaska Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic

Seventeen of Thirty Selected Health Centers Did Not Use or May Not Have Used Their HRSA COVID-19 Supplemental Grant Funding in Accordance With Federal Requirements

Montana Generally Complied With Requirements for Telehealth Services During the COVID-19 Pandemic

Medicare Improperly Paid Providers for Some Psychotherapy Services, Including Those Provided via Telehealth, During the First Year of the COVID-19 Public Health Emergency

University of Cincinnati’s Use of Higher Education Emergency Relief Fund Student Aid and Institutional Grants

Illinois Generally Complied With Requirements for Claiming Medicaid Reimbursement for Telehealth Payments During COVID-19

IHS Did Not Always Provide the Necessary Resources and Assistance To Help Ensure That Tribal Programs Complied With All Requirements During Early COVID-19 Vaccination Program Implementation

Michigan’s Administration of the Governor’s Emergency Education Relief Fund

Oklahoma’s Administration of the Governor’s Emergency Education Relief Fund Grant

An Estimated 91 Percent of Nursing Home Staff Nationwide Received the Required COVID-19 Vaccine Doses, and an Estimated 56 Percent of Staff Nationwide Received a Booster Dose

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