Reports

Department of Homeland Security OIG

Ineffective Controls Over COVID-19 Funeral Assistance Leave the Program Susceptible to Waste and Abuse

The Federal Emergency Management Agency (FEMA) did not always implement effective internal controls to provide oversight of COVID-19 Funeral Assistance. FEMA’s funeral assistance program greatly expanded the universe of reimbursable expenses for deaths related to COVID-19, even beyond those specifically identified as ineligible under established FEMA policy, without establishing guardrails to ensure relief was limited to necessary expenses and serious needs as required by statute.

Full Details: Oversight.gov Report Page

Audit | 8/24/2023

1 - Open

We recommend that the FEMA Administrator resolve questioned costs totaling an estimated $24,438,662 for expenses deemed ineligible by FEMA’s Individual Assistance Program and Policy Guide and determine the amount of any debts owed by recipients for erroneous payments.

2 - Closed

We recommend that the FEMA Administrator resolve other questioned costs included in our report and determine the amount of any debts owed by recipients for erroneous payments. Other questioned costs requiring resolution include: a) $1,348,546 for awards issued to multiple applicants for the same decedents; b) $554,653 for awards issued for applications that exceeded the $9,000 per decedent award limit; and c) $591,805 for 93 applications for which FEMA did not adequately review eligibility criteria of the applications.

3 - Open

We recommend that the FEMA Administrator ensure that future iterations of the Individual Assistance Program and Policy Guide and supporting procedures (a) provide consistent guidance on eligibility of funeral expenses for all future disaster declarations; and (b) allow for reimbursement of only necessary expenses and serious needs, consistent with the law.

4 - Closed

We recommend that the FEMA Administrator strengthen and monitor improvement of FEMA’s COVID-19 Funeral Assistance training practices with particular focus on: a) distinguishing legitimate sources of potential duplication such as decedent’s name and social security number from potential duplications that arise due to FEMA using a repurposed Individual Assistance processing system, with a data field such as damaged dwelling address; b) preventing FEMA from reimbursing expenses exceeding the maximum $9,000 per decedent; and c) deducting financial assistance received from outside sources such as pre-need funeral arrangements, burial insurance, and assistance from other voluntary or government agencies.

5 - Open

We recommend that the FEMA Administrator ensure that FEMA provides its COVID-19 Funeral Assistance call center contractor the guidance and training necessary to meet the quality control and production monitoring metrics as prescribed by its agreement with the contractor.

Department of Health & Human Services OIG

Although IHS Allocated COVID-19 Testing Funds To Meet Community Needs, It Did Not Ensure That the Funds Were Always Used in Accordance With Federal Requirements

Full Details: Oversight.gov Report Page

Audit | 7/20/2023

23-A-07-091.01 - Open

We recommend that the Indian Health Service correct Purpose Statute violations totaling $19,912 relating to funds not used on COVID-19 testing and other testing-related activities from the Pine Ridge Service Unit (an IHS Direct program), and, if IHS is unable to correct those violations, report any Antideficiency Act violations.

23-A-07-091.02 - Open

We recommend that the Indian Health Service identify and correct any other Purpose Statute violations relating to funds not used on COVID-19 testing and other testing-related activities from the Families First Act and Paycheck Protection Act funds allocated to the IHS Direct programs within the GPAO, and, if IHS is unable to correct those violations, report any Antideficiency Act violations.

23-A-07-091.03 - Open

We recommend that the Indian Health Service recover $460,525 in funds not used on COVID-19 testing and other testing-related activities from the applicable sampled Tribal and UIO programs.

23-A-07-091.04 - Open

We recommend that the Indian Health Service identify and recover amounts not used for COVID-19 testing or other testing-related activities that we did not sample from remaining Tribal and UIO programs within the GPAO.

23-A-07-091.05 - Open

We recommend that the Indian Health Service develop and implement procedures to identify and deobligate any unused Families First Act funds that expired on September 30, 2022, from all locations within the GPAO.

23-A-07-091.06 - Open

We recommend that the Indian Health Service develop and provide adequate guidance to programs within the GPAO on the proper use of Paycheck Protection Act funds in accordance with Federal requirements.

23-A-07-091.07 - Open

We recommend that the Indian Health Service strengthen its review process to ensure that modifications to ISDEAA agreements and IHCIA/FAR contracts contain complete and accurate information, including the funding source, amount awarded, and applicable language required under the funding source.

23-A-07-091.08 - Open

We recommend that the Indian Health Service provide adequate guidance to the programs on how to track and account for funds allocated and used under the Paycheck Protection Act.

23-A-07-091.09 - Open

We recommend that the Indian Health Service work with Tribal and UIO programs within the GPAO that we did not sample to ensure that they have properly tracked and accounted for funds used under the Paycheck Protection Act.

Department of Health & Human Services OIG

HRSA Made COVID-19 Uninsured Program Payments to Providers on Behalf of Individuals Who Had Health Insurance Coverage and for Services Unrelated to COVID-19

Full Details: Oversight.gov Report Page

Audit | 7/13/2023

Department of Health & Human Services OIG

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

Full Details: Oversight.gov Report Page

Audit | 5/18/2023

Department of Health & Human Services OIG

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

Full Details: Oversight.gov Report Page

Audit | 5/17/2023

Department of Health & Human Services OIG

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

Full Details: Oversight.gov Report Page

Audit | 5/02/2023

23-A-09-068.01 - Open

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 Homeland Security OIG

FEMA Did Not Provide Sufficient Oversight of Project Airbridge

The Federal Emergency Management Agency (FEMA) did not provide sufficient oversight of Project Airbridge, a COVID-19 initiative. Under unprecedented pressure to mitigate disruptions in global medical supply chains, FEMA established Project Airbridge.

Full Details: Oversight.gov Report Page

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

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

Ineffective Controls Over COVID-19 Funeral Assistance Leave the Program Susceptible to Waste and Abuse

Although IHS Allocated COVID-19 Testing Funds To Meet Community Needs, It Did Not Ensure That the Funds Were Always Used in Accordance With Federal Requirements

HRSA Made COVID-19 Uninsured Program Payments to Providers on Behalf of Individuals Who Had Health Insurance Coverage and for Services Unrelated to COVID-19

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

FEMA Did Not Provide Sufficient Oversight of Project Airbridge

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

Glossary

Glossary name will go here