Reports

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

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 the Interior OIG

The Omaha Tribe Did Not Account for CARES Act Funds Appropriately

We determined that the Omaha Tribe did not follow applicable requirements in an agreement with the BIA.

Full Details: Oversight.gov Report Page

Audit | 12/29/2022

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 the Interior OIG

The Three Affiliated Tribes Did Not Account for CARES Act Funds Appropriately

We determined that the Three Affiliated Tribes did not follow applicable requirements in an agreement with the BIA.

Full Details: Oversight.gov Report Page

Audit | 9/28/2022

Department of the Interior OIG

The Lower Brule Sioux Tribe Did Not Account for CARES Act Funds Appropriately

We determined that the Lower Brule Sioux Tribe did not follow applicable requirements in its agreements with the BIA.

Full Details: Oversight.gov Report Page

Railroad Retirement Board OIG

The RRB Did Not Have Detailed Project Plans to Expend Information Technology Modernization Funds

Full Details: Oversight.gov Report Page

Audit | 6/29/2022

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

Department of Health & Human Services OIG

National Snapshot of Trends in the National Domestic Violence Hotline's Contact Data Before and During the COVID-19 Pandemic

Full Details: Oversight.gov Report Page

Railroad Retirement Board OIG

Railroad Retirement Board Did Not Implement Sufficient Internal Controls in the Mobile Phones Deployed as a Result of the Pandemic

Full Details: Oversight.gov Report Page

Audit | 3/17/2022

1 - Open

The Bureau of Information Services should update their mobile phone policies to include and implement a National Archives and Records Administration-approved records schedule and transfer procedures for electronic records associated with mobile phones.

10 - Open

The Bureau of Information Services should develop and implement a records management and retention system for electronic records.

11 - Open

The Bureau of Information Services should research the capabilities of Railroad Retirement Board's Microsoft Azure Cloud's functionality to determine feasibility of incorporating the automated records management and retention capabilities to govern the mobile phones electronic records.

2 - Open

The Bureau of Information Services should submit a yearly affidavit to confirm electronic records associated with mobile phones have been identified and retained until the full transition into Microsoft Azure Cloud.

3 - Open

The Railroad Retirement Board's Director of Administration should define and communicate 'personal usage' establishing Railroad Retirement Board's core hours of 5:00 am to 7:00 pm. Any usage outside of core hours would be considered personal usage excluding business management purposes.

4 - Open

The Railroad Retirement Board's Bureau of Information Services should 1) continue efforts to update the Telecommuting and Mobile Security Computing Policy with current laws and regulations and 2) develop a periodic monitoring control to assess personal usage and address it according to agency guidance.

5 - Open

The Bureau of Information Services should incorporate the mobile phones in an existing assessable unit and update their mobile phone policies to include documentation regarding the specific roles and responsibilities of each office overseeing the mobile phone program.

6 - Open

The Bureau of Information Services should enforce and execute a review and approval process for application and software download and restrict access to specified applications found in their Railroad Retirement Board G-6 Rules of Behavior.

7 - Open

The Bureau of Information Services should implement procedures to periodically track, log, and monitor iPhone usage and the completion of the G-6 Acknowledgement Statement.

8 - Open

The Bureau of Information Services should periodically review the mobile phone inventory for completeness and accuracy to include a comparison with Railroad Retirement Board's personnel position index.

9 - Open

The Bureau of Information Services should implement the use of unique identifiers between disparate data sets (e.g., mobile phone inventory, personnel position index) to facilitate comparisons and reconcile inconsistent information.

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Reports

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

The Omaha Tribe Did Not Account for CARES Act Funds Appropriately

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

The Three Affiliated Tribes Did Not Account for CARES Act Funds Appropriately

The Lower Brule Sioux Tribe Did Not Account for CARES Act Funds Appropriately

The RRB Did Not Have Detailed Project Plans to Expend Information Technology Modernization Funds

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

National Snapshot of Trends in the National Domestic Violence Hotline's Contact Data Before and During the COVID-19 Pandemic

Railroad Retirement Board Did Not Implement Sufficient Internal Controls in the Mobile Phones Deployed as a Result of the Pandemic

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