Reports

The objectives of this audit are to: 1) obtain, review, and assess agency plans to expend these funds, 2) determine the current status of the RRB IT initiatives to expend all or part of the appropriation, 3) evaluate if the project progress is in accordance with the RRB’s project plan timeline, and reasons for delay, if any, 4) evaluate if the RRB’s goals and timeline are reasonable and attainable to achieve the intended purpose as stated in agency plans, and 5) evaluate the outcomes of the project relative to the anticipated improvements.

The objectives of this audit are to: 1) determine if mobile phones purchased and deployed as a result of the pandemic comply with RRB mobile device policies including records retention for voice mail, text messages, photographs, etc, 2) conduct a cost benefit analysis for the cell phones that would include identification of non-usage of cell phones and extensive personal usage, 3) assess the necessity for the mobile phone, for the entire population of cell phones, based on cell phone usage tied to employee positions within the agency, 4) assess the types of the applications downloaded to the mobile phones and determine if they are appropriate for business purposes and if approvals were required, and 5) assess whether agency records of mobile phone assignment are accurate and complete for the entire population of cell phones.

The preliminary objectives of this audit cover the extended unemployment and sickness benefits that were appropriated through the CARES Act, CARWA, and ARPA to determine if (1) they were accurately expended, recorded, and reported and (2) internal controls were effective, including fraud controls.

Immunization Information Systems (IISs) play an integral role in monitoring vaccine uptake in the population and meeting vaccination goals. While the Centers for Disease Control and Prevention (CDC) and other stakeholders have long invested significant efforts to establish plans and standards to guide improvements in IISs, State, and local jurisdictions have often struggled to make these improvements. CDC's work to collect and share data on COVID-19 vaccinations relies heavily on State and local IISs working with Federal systems, but the preexisting limitations of these systems pose challenges for CDC's goal of comprehensive immunization data being made available for clinical and public health uses. This study will examine State and Federal experiences using these systems to collect, share, and monitor data on COVID-19 vaccinations, and identify lessons learned that can improve vaccination data and monitoring for future mass vaccination campaigns as well as routine vaccination programs.

The Health Resources and Services Administration (HRSA) awarded nearly $2 billion in supplemental grant funding to 1,387 health centers nationwide in fiscal year (FY) 2020 to respond to the COVID-19 public health emergency. The funding was intended to support the health centers' activities related to the detection, prevention, diagnosis, and treatment of COVID-19, including maintaining or increasing health center capacity and staffing levels during the pandemic, and expanding COVID-19 testing. The performance period for each of these one-time supplemental grant awards, which HRSA began awarding in March 2020, is 12 months. Health centers were permitted to charge to their awards pre-award costs in order to support expenses related to the COVID-19 public health emergency dating back to January 20, 2020. We will determine whether health centers used their HRSA COVID-19 supplemental grant funding in accordance with Federal requirements and grant terms.

The COVID-19 pandemic has disproportionately affected American Indian and Alaska Native (AI/AN) populations nationwide.  We will focus on IHS's coordination of the distribution, allocation, and administration of the vaccine to Tribal Health Programs. The objective of this audit is to determine whether IHS followed the Memorandum of Agreement for the CDC COVID-19 Federal Agency Vaccination Program and the IHS COVID-19 Pandemic Vaccine Plan to coordinate the distribution, allocation, and administration of the vaccines to Tribal Health Programs to protect AI/AN beneficiaries. 

Identifying patients who are at-risk of overdose or abuse is key to addressing this crisis. The COVID-19 pandemic has made this need even more pressing. The National Institutes of Health recently warned that individuals with opioiduse disorder could be particularly hard hit by COVID-19, which is a respiratory virus that attacks the lungs. Respiratory disease is known to increase mortality risks among people taking opioids. This data brief would provide information on opioid utilization among beneficiaries enrolled in Medicare Part D in 2020. 

CDC Immunization and Vaccines for Children Cooperative Agreement awardees, which are typically State and large metropolitan area public health departments, plan for and oversee the vaccine distribution and administration process. Stakeholders have acknowledged challenges early in Phase 1 distribution and dispensing, and note that these challenges will likely span all three phases identified in the CDC's COVID-19 Vaccine Playbook. We will interview all awardees to identify the reported challenges they are facing while distributing and dispensing vaccines. We will also ask awardees about effective strategies to mitigate those challenges, new challenges they anticipate, and how HHS can best support them in distributing and dispensing COVID-19 vaccines. In doing so, this review will provide HHS with timely and actionable information to address challenges associated with the COVID-19 vaccination efforts.

Our preliminary analysis has shown that the number of non-COVID-19 tests billed for Medicare Part B beneficiaries during the COVID-19 pandemic has decreased compared with the 6-month period before the pandemic, and many independent laboratories have encountered challenges in providing COVID-19 testing. We will conduct a series of audits on Medicare Part B laboratory services during the pandemic that will initially focus on the effect of the pandemic on non-COVID-19 testing. The series of audits will also focus on aberrant billing of COVID-19 testing during the pandemic.

HHS established contracts under the Public Health and Social Services Emergency Fund to prevent, prepare for, and respond to the COVID-­19 pandemic. The contracts cover more than 600 COVID-19 testing sites in 48 states and the District of Columbia. The contracts utilize a Federal bundled payment program paid directly to retailers that receive a flat fee for each test administered, with participating retailers responsible for coordinating the full, end-to-end testing. The contracts that HHS awarded to contractors were sole source contracts totaling approximately $1 billion for COVID-19 testing. We will review the awarding and management of contracts for COVID-19 testing to determine compliance with applicable Federal statutes, regulations, HHS policies and procedures, contract terms and conditions, and the allowability of claimed costs.