Reports

With emerging information on rates of infection and outcomes for the ongoing coronavirus disease 2019 (COVID-19), numerous reports document a disproportionate burden of infection and deaths among communities of color and economically disadvantaged communities. This study will examine data that the Centers for Disease Control and Prevention (CDC) collects and maintains that can be used to assess racial, ethnic, and socioeconomic disparities in COVID-19 cases and outcomes, as well as how CDC uses those data as part of its activities to address the COVID-19 pandemic. We will also examine CDC's lessons learned about how to best protect communities of color and economically disadvantaged communities in future public health emergencies. 

On March 27, 2020, the President signed into law the Coronavirus Aid, Relief, and Economic Security Act (CARES Act), which provided the U.S. Department of the Interior (DOI) with $756 million to support the needs of DOI programs, bureaus, Indian Country, and the Insular Areas. As part of the CARES Act, the Bureau of Indian Education (BIE) received $69 million from the DOI to prevent, prepare for, and respond to the coronavirus pandemic. In addition to the CARES Act funding appropriated directly to the DOI, the CARES Act’s Education Stabilization Fund required the U.S. Department of Education...

CARES Act Section 3610 allows Federal agencies to reimburse their contractors and subcontractors for any paid leave, including sick leave, that the contractors provide to keep their employees or subcontractors in what the section refers to as a “ready state.” Because these reimbursements present a number of risks and the U.S. Department of the Interior (DOI) is already receiving Section 3610 claims from contractors, the DOI urgently needs to put policies in place to ensure consistent oversight of reimbursed leave costs. In this management advisory memorandum, we offer three recommendations...

Medicaid is a joint Federal-State program that pays for medical assistance for individuals and families with low incomes. All States currently provide coverage for outpatient prescription drugs within their State Medicaid programs. Under section 1135 of the Act, CMS may temporarily waive or modify certain Medicaid requirements to ensure that sufficient health care items and services are available to meet the needs of beneficiaries in times of an emergency. The coronavirus disease 2019 (COVID-19) pandemic highlights the need for States to efficiently and effectively respond to protect the needs of Medicaid beneficiaries. This audit will provide insights from State officials on action taken by States and DC to ensure Medicaid beneficiaries continue to receive prescriptions during the COVID-19 pandemic. We will interview State officials from several States and DC to determine actions taken or planned. Our objective is to review actions taken or planned by States and DC to ensure Medicaid beneficiaries continue to receive prescriptions during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) pandemic has led to an unprecedented demand for diagnostic laboratory testing to determine whether an individual has the virus. Beyond the COVID-19 tests, laboratories can also perform add-on tests, for example to confirm or rule out diagnosis other than COVID-19. However, OIG has program integrity concerns related to add-on tests in conjunction with COVID-19 testing, particularly related to potentially fraudulent billing for associated respiratory pathogen panel (RPP) tests, allergy tests, or genetic tests. The Centers for Medicare & Medicaid Services has relaxed rules related to COVID-19 testing and other associated diagnostic laboratory testing to no longer require an order from the treating physician or non-physician practitioner (NPP) during the COVID-19 public health emergency. Relaxation of the physician ordering/NPP rules could allow unscrupulous actors more leeway for fraudulent billing of unnecessary add-on testing. This study will examine Medicare claims data for laboratory testing to identify trends in the use of RPP, allergy, and genetic testing and identify patterns of billing by laboratories that may indicate fraud and abuse.

In response to the outbreak of the Coronavirus (COVID-19), the National Park Service (NPS) closed most park buildings, facilities, and restrooms, and in some cases, entire parks. With States now easing stay-at-home restrictions, and in response to the White House’s emphasis to open the national parks, some parks have already increased access by implementing a phased reopening. To facilitate a safe reopening, the NPS issued the National Park Service COVID-19 Adaptive Operations Recovery Plan to the parks on May 28, 2020. We contacted each of the 62 national park superintendents to report on...

The DOI will award most of its CARES Act funding to Indian Country through grants to the Bureau of Indian Affairs (BIA) and the Bureau of Indian Education (BIE). Of the $756 million, $522 million (69.0 percent) will be funded to Indian Country. As of June 13, 2020, $419,462,721, or 80.4 percent, had been obligated. These emergency response awards from the DOI–together with more than $8.7 billion in awards to Indian Country from other Federal departments—present a higher risk because they must be spent in a short period of time. In addition, we have identified Indian Country as a high-risk area...

As a result of the coronavirus disease 2019 (COVID-19) pandemic, State Medicaid programs have expanded options for telehealth services. Rapid expansion of telehealth may pose challenges for State agencies and providers, including State oversight of these services. Our objective is to determine whether State agencies and providers complied with Federal and State requirements for telehealth services under the national emergency declaration, and whether the States gave providers adequate guidance on telehealth requirements.

Title IV-E of the Social Security Act (the Act), as amended, authorizes the Federal Foster Care Program, which helps provide safe and stable out-of-home care for children until the children are safely returned home, placed permanently with adoptive families, or placed in other planned arrangements for permanency. Title IV-B of the Act authorizes Federal funding to States to promote flexibility in the development and expansion of coordinated child and family services programs. In response to COVID-19, on April 15, 2020, the Children's Bureau the operating division of the Administration for Children and Families (ACF) that administers the Title IV-B and Title IV-E programs at the Federal level—provided flexibility to State Title IV-E agencies related to (1) fingerprint-based criminal record checks requirements for prospective foster parents (allowing for name-based checks until fingerprint-based checks can safely be done), and (2) caseworker visit requirements (allowing videoconferencing visits to count toward the requirement that 50 percent of visits must occur in the child's home). On April 27, 2020, the Children's Bureau reminded States of additional flexibilities afforded by the Statute, including the authority to modify foster family licensing standards as long as the standards are applied to all of these placements in accordance with the requirements of the Statute. Additionally, States have the authority to set their own foster care maintenance payment rates including, at their own discretion, enhancing those rates for children who test positive for COVID-19.

We intend to survey all States and identify the States that adopted any new licensing regulations or policies and procedures as a result of the existing flexibilities in the Statute and the waivers provided by ACF. Based on the information gathered, we plan to identify three States and conduct separate audits to ensure foster care providers are safeguarding the health and safety of children during the COVID-19 pandemic and identify any vulnerabilities or gaps in policies or procedures that could place these children at risk. As part of these audits, we would ensure that criminal record checks for foster parents conducted via name-based checks were ultimately conducted through fingerprints whenever determined safe to do so.