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Pandemic Response Accountability Committee

COVID Testing at Select Federal Healthcare Programs

This cross-agency project will examine COVID testing at select federal healthcare programs. To complete the work, participating OIGs will identify and report COVID-19 testing data and relevant department information. 
Department of Justice

Review Examining BOP’s Use of Home Confinement as a Response to the COVID-19 Pandemic

The Office of the Inspector General (OIG) has initiated a review of the Federal Bureau of Prisons’ (BOP) use of home confinement as a tool to mitigate the effect of the Novel Coronavirus Disease (COVID-19) pandemic on the federal prison population.  The review will assess the BOP’s process for implementing the use of home confinement as authorized under the CARES Act, the process for its consideration of the eligibility criteria outlined in the Attorney General’s March 26 and April 3, 2020 memoranda, and the process by which BOP headquarters evaluated wardens’ recommendations that inmates who did not meet the Attorney General’s criteria be placed in home confinement.  The review will also select particular cases for examination to determine whether there were irregularities in the BOP’s processes.  If circumstances warrant, the OIG will consider including other issues that may arise during the course of the review.  The OIG is undertaking this review in response to requests from Members of Congress, and issues the OIG identified during the series of remote inspections it has conducted regarding the BOP’s response to the COVID-19 pandemic.
Department of Health and Human Services OIG

COVID-19 Testing Data from Federal Programs

The Coronavirus Aid, Relief, and Economic Security (CARES) Act created the Pandemic Response Accountability Committee (PRAC). PRAC's mission is to promote transparency and support the coordinated oversight of the Federal Government's coronavirus response in order to prevent and detect fraud, waste, abuse, and mismanagement, and to mitigate major risks that cross program and agency boundaries. PRAC members include Offices of Inspectors General (OIG) at Federal agencies, some of which operate, utilize, or are otherwise impacted by health care programs. Within PRAC, the Health Subgroup has identified major risks areas, including COVID-19 testing, that are critical to the Federal Government's response efforts. PRAC's Health Subgroup includes OIGs from the Departments of Defense (DOD), Education, Health and Human Services (HHS), Labor (DOL), and Veterans Affairs (VA), as well as the Office of Personnel Management (OPM). HHS-OIG will work with PRAC to produce a data brief describing COVID-19 testing in Federal health-related programs managed or operated by DOD, DOL, DOJ, HHS, OPM, and the VA. The data brief can help provide transparency and inform policymakers about COVID-19 testing resources in Federal programs. This project will involve coordination with OIGs from the six agencies.
Department of Health and Human Services OIG

Infection Control at Home Health Agencies During the COVID-19 Pandemic

The coronavirus that causes the respiratory disease COVID-19 is especially dangerous for adults aged 65 years and older and those with underlying medical conditions. Medicare beneficiaries receiving home health services may be at a high risk of developing severe illness from COVID-19. Home health services are covered for the elderly and disabled under the Medicare program. Home health services may include skilled nursing care, physical therapy, speech-language pathology, occupational therapy, and medical supplies. Home health agencies (HHAs) must meet certain requirements to participate in the Medicare and Medicaid programs, including meeting infection prevention and control standards. On March 10, 2020, CMS issued a State Survey Directors Letter, "Guidance for Infection Control and Prevention Concerning Coronavirus Disease 2019 (COVID-19) in Home Health Agencies (HHAs)," to provide HHAs with guidance on addressing the outbreak and minimizing transmission. Home health workers often travel to several homes on a weekly basis, which increases their risk of exposure to the COVID-19 and increases the risk of infection among Medicare beneficiaries. HHAs must maintain a coordinated agencywide program for the surveillance, identification, prevention, control, and investigation of infectious and communicable diseases. We will interview corporate officers from the three HHA providers with the largest market share in 2019 as well as HHAs that have recently been cited by CMS for infection control and prevention deficiencies to determine the extent to which their infection control and prevention policy and procedures comply with CMS guidance regarding COVID-19.
Department of Health and Human Services OIG

HHS and ASPR Actions Related to Resources, Supplies, and Treatments Needed to Address COVID-19

HHS may take a variety of actions in response to an emerging infectious disease, including, but not limited to, actions related to resources, supplies, and treatments needed to address COVID-19. This study will examine actions taken by HHS, including the Office of Assistant Secretary for Preparedness and Response, to protect public health in response to the COVID-19 pandemic.
Pandemic Response Accountability Committee

Sole Source Contracting

This cross-agency project will examine federal contracts related to the COVID-19 pandemic that were awarded to first-time federal contractors without competitive bidding.
Department of Homeland Security OIG

Audit of USCIS' Ability to Process and Administer Immigration and Naturalization Benefits Requests During the COVID-19 Pandemic

Determine the effectiveness of U.S. Citizenship and Immigration Services’ (USCIS) technology systems to provide timely and accurate electronic processing of immigration and naturalization benefit requests while field locations, asylum offices and application support centers were closed or operating on a reduced workforce during the COVID-19 pandemic.
Department of Health and Human Services OIG

Audit of Foundational Cybersecurity Controls for the U.S. Healthcare COVID-19 Portal and Protect.HHS.gov

 The Protect.HHS.gov ecosystem and the U.S. Healthcare COVID-19 portal are both critically important systems contributing to the Federal pandemic response. The data collected by these systems are utilized in the response to COVID-19 by, for example, tracking the movement of the virus, identifying potential stresses in the health care delivery system, and provide information about the distribution of supplies. Without proper cybersecurity, the integrity and availability of the data are at risk and the impact to public health efforts could be significant if decisionmakers cannot rely on COVID-19 data from States, communities, and hospitals. We will determine whether HHS has implemented foundational cybersecurity controls to ensure the integrity and availability of Protect.HHS.gov and the U.S. Healthcare COVID-19 portal.
Department of Health and Human Services OIG

Infection Control and Emergency Preparedness at Dialysis Centers During the COVID-19 Pandemic

CDC has stated that beneficiaries with serious underlying medical conditions, such as end-stage renal disease (ESRD), are at higher risk for severe illness from COVID-19. Regardless of the current pandemic, dialysis patients are at high risk of infection because of weakened immune systems, coexisting conditions such as diabetes, and treatments requiring frequent use of catheters or insertions of needles to access the bloodstream. ESRD facility conditions for coverage regarding infection control and emergency preparedness are defined in 42 CFR 494 Subpart B. On March 30, 2020, CMS issued a revised memorandum providing guidance for infection control and prevention of COVID-19 in dialysis facilities. We will interview corporate officers from the three ESRD service companies covering more than 75 percent of CY 2018 Medicare reimbursements and 71 percent of dialysis clinics. Our objective is to determine whether ESRD facilities implemented additional infection control and emergency preparedness procedures in accordance with CMS and CDC guidance to safeguard high risk ESRD beneficiaries during the COVID-19 pandemic.
Department of Health and Human Services OIG

Audit of CARES Act Provider Relief Funds—General and Targeted Distributions to Hospitals

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and the Paycheck Protection Program and Health Care Enhancement Act appropriated $175 billion for the Provider Relief Fund (PRF) to support health care providers affected by the COVID-19 pandemic. In April 2020, the Health Resources and Services Administration began distributing the funds through general distributions to Medicare providers based on 2018 net patient revenue and targeted distributions for certain provider types (e.g., providers in areas particularly impacted by COVID-19, skilled nursing providers, and providers in rural areas). Providers such as hospitals may be eligible for PRF payments from the general and targeted distributions. We will select for audit a statistical sample of providers that received general and/or targeted distributions. Our objective is to determine whether providers that received PRF payments complied with certain Federal requirements, and the terms and conditions for reporting and expending PRF funds.