Reports

Department of Homeland Security OIG

FEMA Did Not Effectively Manage the Distribution of COVID-19 Medical Supplies and Equipment

Although the Federal Emergency Management Agency (FEMA) worked with its strategic partners to deliver critical medical supplies and equipment in response to COVID-19, FEMA did not effectively manage the distribution process. Specifically, FEMA did not use the Logistics Supply Chain Management System (LSCMS), its system of record for managing the distribution process, to track about 30 percent of the critical medical resources shipped, as required.

Full Details: Oversight.gov Report Page

Audit | 7/20/2023

1 - Closed

We recommend the FEMA Administrator clarify existing guidance and ensure FEMA personnel use the Logistics Supply Chain Management System or an alternative integrated solution as the system of record during disaster response operations to manage the distribution of FEMA-owned commodities, supplies, and equipment as well as those sourced by FEMA from partners across the Federal Government, non-governmental organizations, and the private sector to fulfill state, local, tribal, and territorial requests.

2 - Open

We recommend the FEMA Administrator take action to develop and improve the Logistics Management Directorate’s internal controls, guidance, and system integration to obtain more accurate information that enhances logistics decision making regarding the fulfillment of commodity requests during disaster response operations. At a minimum, FEMA should: a. develop internal controls to ensure appropriate information related to facility types, intermediate locations, and transportation-only orders is accurately reported in the Logistics Supply Chain Management System or an alternative integrated solution; b. update guidance and deliver training to ensure there is a clear audit trail when aggregating distribution data on FEMA-owned commodities, supplies, and equipment as well as those sourced by FEMA from partners across the Federal Government, non-governmental organizations, and the private sector to fulfill state, local, tribal, and territorial requests; and c. improve integration between the Logistics Supply Chain Management System and the Web Emergency Operations Center Crisis Management System to ensure the systems are, to the extent practicable, compatible and share information as required by the Post-Katrina Emergency Management Reform Act of 2006.

3 - Open

We recommend the FEMA Administrator issue guidance and ensure a standardized process for collecting and maintaining documentation to confirm delivery and receipt of FEMA-owned commodities, supplies, and equipment, as well as those sourced by FEMA from partners across the Federal Government, non-governmental organizations, and the private sector to fulfill state, local, tribal, and territorial requests. At a minimum, the guidance and standardized process should: a. identify the required types of documentation to confirm delivery and receipt such as signed bills of lading, packing slips, and other forms; b. include controls to ensure the shipment documentation includes item descriptions and the specific quantity of items delivered and received; c. clarify the procedures for executing and documenting the delivery of commodities, supplies, and equipment to locations where no FEMA personnel are present to receive shipments; and d. establish appropriate repositories for delivery and receipt documentation.

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

Targeted Provider Relief Funds Allocated to Hospitals Had Some Differences with Respect to the Ethnicity and Race of Populations Served

Full Details: Oversight.gov Report Page

Wisconsin Legislative Audit Bureau

Department of Workforce Development: Unemployment Reserve Fund (FY 2020-21 and FY 2021-22)

As part of our financial statements audit of the Unemployment Reserve Fund, which accounts for Wisconsin’s Unemployment Insurance program paid to eligible individuals, we provided an unmodified opinion on the Fund’s financial statements and related notes as of and for the years ended June 30, 2022, and June 30, 2021. We found the assets of the Reserve Fund exceeded liabilities at the close of fiscal year (FY) 2021-22 by almost $1.4 billion. Except for $19.2 million in certain federal allocations, the Fund’s net position, if positive, can be used only to pay unemployment benefits to eligible...

Department of Health & Human Services OIG

Alaska Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic

Full Details: Oversight.gov Report Page

Audit | 6/02/2023

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 Veterans Affairs OIG

VHA Can Improve Controls Over Its Use of Supplemental Funds

The Coronavirus Aid, Relief, and Economic Security (CARES) Act appropriated about $17.2 billion in supplemental funds to the Veterans Health Administration (VHA) to support VA’s efforts to prevent, prepare for, and respond to the COVID-19 pandemic. The OIG conducted this audit to assess the effectiveness of VA’s controls over VHA’s use of these funds. Because VA’s financial management system does not support the direct obligation of supplemental funds for all expenses, staff used expenditure transfers to shift funds between appropriation accounts. Expenditure transfers are documented using...

Full Details: Oversight.gov Report Page

Audit | 5/09/2023

01 - Closed

VA’s assistant secretary for management and chief financial officer assess the iFAMS configuration to determine whether integration with the payroll subsystems can be accomplished to resolve some of the payroll-related issues that require the need for expenditure transfers.

01 - Closed

Assess the iFAMS configuration to determine whether integration with the payroll subsystems can be accomplished to resolve some of the payroll-related issues that require the need for expenditure transfers.

02 - Closed

Establish guidance that outlines the type of documentation required to support the amounts identified in the manual journal vouchers when processing expenditure transfers.

03 - Open

VA’s under secretary for health require medical facility staff have documented authority, through proper delegation, to make purchases.

04 - Open

VA’s under secretary for health verify that medical facility staff segregate duties so that the same person is not both authorizing and receiving goods and services.

05 - Open

VA’s under secretary for health make certain the purchase card holder is not the requestor or approver for the purchase.

06 - Open

VA’s under secretary for health ensure contracting officer’s representatives know and understand their duties and responsibilities for the certification and payment of invoices.

07 - Open

VA’s under secretary for health check vendors’ compliance with contract terms to include the comparison of invoiced amounts with the contract line-item unit costs.

08 - Open

VA’s under secretary for health ensure that medical facility staff track the receipt of goods to make certain they are the correct quantity.

09 - Closed

Conduct an assessment of lessons learned from the emergency response to the pandemic and develop appropriate action plans to integrate oversight roles, responsibilities, and clear guidance into the use of supplemental funds.

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.

Wisconsin Legislative Audit Bureau

Administration of Certain Supplement Federal Funds: Department of Health Services

From March 2020 through June 2022, the Department of Health Services (DHS) awarded $159.6 million in program grants to 1,431 long-term health care and emergency medical services providers. We question $518,700 that DHS paid to 10 grant applicants that did not submit sufficient documentation to support their grant applications or the grant amounts they requested. We provide recommendations to DHS to improve how it administers its grant programs and its Ventilator Stewardship program. We also recommend DHS improve how its Office of Inspector General ensures program integrity.

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Reports

FEMA Did Not Effectively Manage the Distribution of COVID-19 Medical Supplies and Equipment

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

Targeted Provider Relief Funds Allocated to Hospitals Had Some Differences with Respect to the Ethnicity and Race of Populations Served

Department of Workforce Development: Unemployment Reserve Fund (FY 2020-21 and FY 2021-22)

Alaska Experienced Challenges in Meeting Federal and State Foster Care Program Requirements During the COVID-19 Pandemic

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

VHA Can Improve Controls Over Its Use of Supplemental Funds

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

Administration of Certain Supplement Federal Funds: Department of Health Services

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