Reports

The Office of Inspector General is issuing this management advisory to present the results of our review of the U.S. Small Business Administration’s (SBA) incomplete reviews of Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loans (EIDL) and grants disbursed to borrowers who self-disclosed their business establishment dates after January 31, 2020. SBA asserted that the Coronavirus Aid, Relief, and Economic Security (CARES) Act requirement for a business to be in operation on or before January 31, 2020, applied only to COVID-19 EIDLs, not Emergency EIDL Advances. The Office of...

The Office of Inspector General is issuing this management advisory to gain an understanding of the U.S. Small Business Administration’s (SBA) Coronavirus Disease 2019 (COVID-19) servicing processes and determine its capability to service more than 2 million COVID-19 Economic Injury Disaster Loans (EIDL). We found the COVID-19 EIDL Servicing Center (CESC) demonstrated that it was capable of servicing over 2 million COVID EIDLs during the period of our review. The CESC appeared to be adequately staffed as evidenced by its ability to complete over 23,500 servicing actions per month with an...

The Office of Inspector General (OIG) is issuing this Evaluation Report to determine whether the U.S. Small Business Administration (SBA) made Paycheck Protection Program (PPP) loans in accordance with program size standards. This is a follow-up to our earlier report which identified 355 PPP loans that likely exceeded the maximum size standard and may have been erroneously approved. Based on updated data analysis, we identified that 79 of those 355 loans still appeared to exceed the maximum size standard. Our objective was to determine whether PPP loans were made in accordance with program...

This report presents the results of our management advisory bringing the Small Business Administration’s (SBA) attention to concerns regarding forgiven Paycheck Protection Program (PPP) loans subsequently flagged as potentially ineligible using hold code 70 (potential clawback) for which the agency has not completed its review to facilitate recovery of improper payments for ineligible loans. A hold code is an identifier placed on a loan in the agency’s system indicating a potential issue needs to be resolved. SBA uses hold code 70 to flag forgiven PPP loans for which it subsequently suspects...

This report updates Congress on progress made by the U.S. Small Business Administration (SBA) on the 39 open pandemic-related recommendations referenced in Office of Inspector General (OIG) Report 23-09, COVID-19 Pandemic EIDL and PPP Loan Fraud Landscape. Over the course of the Coronavirus Disease 2019 (COVID-19) pandemic, SBA disbursed approximately $1.2 trillion of COVID-19 Economic Injury Disaster Loan and Paycheck Protection Program funds. The economic assistance was intended to help eligible small business owners and entrepreneurs adversely affected by the crisis. In Report 23-09, we...

The Office of Inspector General (OIG) is issuing this management advisory to bring attention to concerns regarding SBA’s use of hold codes for potentially fraudulent Paycheck Protection Program (PPP) loans referred by lenders. Opportunities exist for SBA to enhance its handling of lender-referred PPP loans suspected of fraud or illegal activity and its process for capturing these loans to ensure they are promptly flagged to mitigate fraud risk and financial loss. SBA’s Office of Credit Risk Management (OCRM) established a project for lenders to refer PPP loans suspected of fraud or illegal...

The Office of Inspector General (OIG) is issuing this inspection report to determine whether data sharing between the Employment and Training Administration and the U.S. Small Business Administration (SBA) could mitigate the risk of fraudulent unemployment insurance benefit payments and SBA disaster program disbursements. In 2020, soon after Congress expanded the Unemployment Insurance and Economic Injury Disaster Loan Programs in response to the adverse economic effects caused by the Coronavirus Disease 2019 pandemic, the U.S. Department of Labor OIG and SBA OIG respectively began reporting...

Over 5,300 lenders, including bank and non-bank lenders, participated in the Paycheck Protection Program (PPP), an $813.7 billion program that provided forgivable loans to eligible borrowers. The primary distinction between the two is that non-bank lenders are not federally regulated. Both were allowed to partner with third-party service providers to assist in the PPP loan process. We assessed the U.S. Small Business Administration’s (SBA) oversight of non-bank lenders, including financial technology (fintech), and third-party service providers in the PPP. Opportunities exist for SBA to...

The Office of Inspector General is issuing this evaluation report to determine whether the U.S. Small Business Administration (SBA) approved disaster loan applications with related Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loans (EIDL) or Paycheck Protection Program (PPP) loans with fraud hold codes.In October 2022, SBA established an informal review process to match disaster assistance loan applications to pandemic loans that had fraud hold codes based on taxpayer identification numbers. In August 2023, the agency began transitioning to a new system that uses fraud...

This report represents our current assessment of the U.S. Small Business Administration's programs and activities that pose significant risks, including those that are particularly vulnerable to fraud, waste, error, mismanagement, or inefficiencies. The Challenges are not presented in order of priority, as we believe that all are critical management or performance issues.

The Office of Inspector General is issuing this inspection report to assess the U.S. Small Business Administration’s (SBA) processing of Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loan (EIDL) reconsideration requests.SBA began accepting COVID-19 EIDL applications on March 12, 2020, and continued to accept them through December 31, 2021, when the COVID-19 EIDL program ended. COVID-19 EIDL applicants who were not approved for a loan could request the agency reconsider their loan application, initiating the reconsideration process.We found SBA generally processed reconsideration...

The Office of Inspector General (OIG) is issuing this management advisory to bring attention to concerns regarding the U.S. Small Business Administration’s (SBA) post-award review process to monitor Shuttered Venue Operators Grant (SVOG) award recipients’ eligibility, award calculation, and use of funds. The Shuttered Venue Operators Grant (SVOG) program was established on December 27, 2020, as part of the Economic Aid to Hard-Hit Small Businesses, Nonprofits and Venues Act (Economic Aid Act). The program was amended by the American Rescue Plan Act on March 11, 2021, which increased program...

The Office of Inspector General (OIG) is issuing this Inspection report to assess the Small Business Administration’s (SBA) guaranty purchase process for Paycheck Protection Program (PPP) loans. The Coronavirus Aid, Relief, and Economic Security (CARES) Act established the PPP to provide guaranteed SBA loans for eligible businesses, individuals, and nonprofits adversely impacted by the Coronavirus Disease 2019 pandemic. We assessed whether SBA reported and referred charged-off PPP loans to commercial credit reporting agencies and the U.S. Department of Treasury in accordance with applicable...

The OIG is issuing this evaluation to assess whether the U.S. Small Business Administration (SBA) effectively implemented internal controls when using the U.S. Department of the Treasury’s Do Not Pay (DNP) databases to detect and prevent payments of Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loans (EIDL) and grants to ineligible entities.Despite implementing controls requiring loan officers to check DNP databases prior to approval of COVID-19 EIDLs and provide applicants 30 days to rectify any negative information received from DNP, the agency continued to award and disburse...

The Office of Inspector General (OIG) is issuing this Inspection Report to assess the Small Business Administration’s (SBA) process for approving 7(a) loans for borrowers with unresolved pandemic loan compliance issues.From October 1, 2019 through May 8, 2023, SBA approved and disbursed 172,598 7(a) loans, totaling $83.4 billion. The 7(a) lenders who have delegated approval authority approved 92 percent of these loans and SBA approved the remaining 8 percent. SBA implemented a process to screen 7(a) loan applications for eligibility, which included screening for Paycheck Protection Program...

The Office of Inspector General (OIG) is issuing this management advisory to present the results of our review of the U.S. Small Business Administration’s (SBA) processing of Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loan (EIDL) funds that were returned to the agency by borrowers, banks, or other sources.We found significant delays in the decision process related to returned COVID-19 EIDL funds. The majority of these COVID-19 EIDLs were eventually made available to small business owners, including the original borrowers. However, SBA canceled $3.1 billion of these loans...

This SBA OIG pandemic oversight report reviewed the U.S. Small Business Administration’s Restaurant Revitalization Fund application review and approval process. The objective of this review was to determine whether the controls SBA implemented to award RRF program funds in accordance with the Act and other applicable guidance were effective. SBA developed an implementation plan including a risk framework that was intended to reduce the risk of making improper payments and awarding Restaurant Revitalization Funds (RRF) to ineligible recipients. However, the plan did not include all program...

This report is a follow up to SBA OIG Report Number 21-06, Paycheck Protection Program (PPP) Loan Recipients on the Department of Treasury’s (Treasury) Do Not Pay (DNP) List, which reported SBA did not use Department of Treasury (Treasury) DNP data to screen borrowers for eligibility prior to approving loans originated before August 8, 2020 (PPP round one). In this report, we assess SBA actions to address potentially ineligible loans identified in report 21-06 and its implementation of controls to review DNP data for PPP loans originated after August 8, 2020 (PPP round two).SBA implemented a...

This report presents the results of our verification inspection of the U.S. Small Business Administration’s (SBA) corrective actions for the five recommendations from the Office of Inspector General (OIG) evaluation report SBA’s Handling of Identity Theft in the COVID-19 Economic Injury Disaster Loan Program (Report 21-15).We initiated this verification inspection to determine whether the closed recommendations were fully implemented or if further corrective actions were needed. Accordingly, our objective was to determine the effectiveness of the corrective actions SBA implemented to 1)...

This report presents the results of our inspection to assess the U.S. Small Business Administration’s (SBA) Shuttered Venue Operators Grant (SVOG) controls to prevent disbursements to ineligible entities. Specifically, our review focused on general eligibility requirements applicable to all SVOG applicants and venue-specific requirements applicable to live venue operators.SBA delayed launching the SVOG application portal for over 2 weeks in April 2021 because of technical issues. In June 2021, SBA officials made program changes, which SBA called a “program refresh,” to accelerate application...

This report represents our current assessment of the U.S. Small Business Administration's programs and activities that pose significant risks, including those that are particularly vulnerable to fraud, waste, error, mismanagement, or inefficiencies. The Challenges are not presented in order of priority, except for the COVID 19 challenge, which we address first in this report. We also view the other challenges as critically important to SBA operations.

The Small Business Administration's (SBA) Office of Inspector General (OIG) is issuing this management advisory to bring attention to concerns regarding SBA’s decision to end active collections on delinquent COVID-19 Economic Injury Disaster Loans (EIDL) with an outstanding balance of $100,000 or less.First, SBA’s decision to cease collections risks violating the Debt Collection Improvement Act of 1996, which prohibits ending collections on fraudulent, false, or misrepresented claims, because SBA OIG and other oversight agencies are continuing to work on identifying COVID-19 EIDL fraud that...

We reviewed the U.S. Small Business Administration’s (SBA) oversight of Restaurant Revitalization Fund (RRF) recipients. The American Rescue Plan Act of 2021 authorized SBA to administer the RRF and provided $28.6 billion to assist eligible small businesses adversely affected by the Coronavirus Disease 2019 (COVID-19) pandemic.We determined program officials developed a plan for monitoring RRF award recipients use of funds and recovering unused or improperly awarded funds. However, program implementation was not executed in accordance with the plan.We made six recommendations for SBA to...

We reviewed the U.S. Small Business Administration’s (SBA) blanket purchase agreement with Highlight Technologies, LLC for loan support services.To meet the increased demand for Coronavirus Disease 2019 (COVID-19) loan program support services, SBA issued labor hour contracts, e.g. call orders, using an existing blanket purchase agreement. However, SBA contracting officials did not always perform adequate price analyses, awarding contracts that were not the best use of taxpayer funds. SBA did not establish adequate guidance to ensure contracting officials consistently followed federal...

We inspected the U.S. Small Business Administration’s (SBA) administrative process used to review potentially fraudulent Restaurant Revitalization Fund (RRF) applications and recover funds.Program officials designed the RRF application validation and approval processes using the Government Accountability Office’s A Framework for Managing Fraud Risks in Federal Programs. However, 3,790 applications submitted through a point-of-sale partner were processed without verifying gross sales, a key control designed to prevent ineligible entities from receiving awards.As a result, SBA’s RRF application...

The U.S. Small Business Administration (SBA) Office of Inspector General (OIG) conducted this review to provide a comprehensive estimate of the potential fraud in the U.S. Small Business Administration’s (SBA) pandemic assistance loan programs. Over the course of the Coronavirus Disease 2019 (COVID-19) pandemic, SBA disbursed approximately $1.2 trillion of COVID-19 Economic Injury Disaster Loan (EIDL) and Paycheck Protection Program (PPP) funds.In the rush to swiftly disburse COVID-19 EIDL and PPP funds, SBA calibrated its internal controls. The agency weakened or removed the controls...

The Office of Inspector General (OIG) is issuing this management advisory to bring to your attention concerns regarding the return of Paycheck Protection Program (PPP) funds. This issue requires immediate attention and action by the U.S. Small Business Administration (SBA) to ensure it has processes and procedures in place to adequately accept, process, and account for PPP funds returned by borrowers, lenders, and financial institutions. Expedited management action should mitigate the risk of financial loss to taxpayers.Establishing clear and detailed guidance for borrowers, lenders, and...

We prepared this white paper to report on the U.S. Small Business Administration’s (SBA) 7(a) loan program performance during SBA’s response to the Coronavirus Disease 2019 (COVID-19) pandemic and address potential risks SBA should consider in managing the program.We identified factors that could impact the 7(a) loan program and should be considered in SBA’s program risk strategy. Specifically, in FY 2021, the total amount of loans increased to $31.4 billion from $19.4 billion in FY 2020 (62 percent increase) and $20.6 billion in FY 2019 (53 percent increase), as did the average loan amount...

This report represents our current assessment of the U.S. Small Business Administration's programs and activities that pose significant risks, including those that are particularly vulnerable to fraud, waste, error, mismanagement, or inefficiencies. The Challenges are not presented in order of priority, except for the COVID 19 challenge, which we address first in this report. We also view the other challenges as critically important to SBA operations.

The Office of Inspector General (OIG) is issuing this management advisory to express concerns regarding the U.S. Small Business Administration’s (SBA) decision to end collections on purchased Paycheck Protection Program (PPP) loans with an outstanding balance of $100,000 or less.In anticipation of a significant number of delinquent PPP loans that lenders will submit for guaranty purchase, we began reviewing SBA’s process for approving PPP guaranty purchases. During our review, we identified concerns with SBA’s decision to end collections on these loans and found that expedited management...

This report presents the results of our follow-up inspection to assess the effectiveness of the U.S. Small Business Administration’s (SBA) enhanced internal controls to prevent Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loans (EIDL) to ineligible applicants.The Coronavirus Aid, Relief, and Economic Security (CARES) Act prohibited the agency from requiring tax return transcripts to prove eligibility. Congress eliminated this restriction 9 months later with the Consolidated Appropriations Act, 2021. We found SBA did not implement the tax transcript requirement in a timely...

This report presents the results of our audit to determine whether the U.S. Small Business Administration (SBA) maintained effective management control activities and monitoring of the design and implementation of third-party operated SBA systems. SBA needed information technology systems from third-party service providers that could improve the system efficiency and productivity to process high transaction volumes, transmit data between other information systems, and safeguard the integrity and confidentiality of the personally identifiable information processed by the programs.We found the...

The U.S. Small Business Administration (SBA) Office of Inspector General (OIG) conducted this review to assess Paycheck Protection Program (PPP) eligibility for nonprofit organizations. Based on data analysis, we identified 179 PPP loans, totaling approximately $684 million, made to potentially ineligible nonprofits that may have exceeded SBA’s requirements for business size, known as size standards, at the time of application.We also reviewed PPP loans for three large nonprofits, including Planned Parenthood of Illinois that received over $3.8 million, Goodwill of Southwestern Pennsylvania...

We evaluated the U.S. Small Business Administration’s (SBA) controls to flag or prevent potentially fraudulent Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loan (EIDL) applications submitted from foreign Internet Protocol (IP) addresses.Although the agency implemented several layers of controls to prevent or reduce fraud from foreign countries, individuals at foreign IP addresses were able to access the COVID-19 EIDL application system. SBA received millions of attempts to submit COVID-19 EIDL applications from foreign IP addresses and stopped most of them; however, the agency...

The Office of Inspector General (OIG) found that the Small Business Administration (SBA) did not have an organizational structure with clearly defined roles, responsibilities, and processes to manage and handle potentially fraudulent Paycheck Protection Program (PPP) loans across the program. In addition, the agency did not establish a centralized entity to design, lead, and manage fraud risk. This problem occurred because the agency did not establish a sufficient fraud risk framework at the start of and throughout PPP implementation. Management stated this was partly due to the speed of the...

The Office of Inspector General (OIG) evaluated the U.S. Small Business Administration’s (SBA) procedures to award a contract for data analysis and loan recommendation services for Economic Injury Disaster Loan (EIDL) applications and Targeted EIDL Advance applications related to the Coronavirus Disease 2019 (COVID-19) pandemic.To increase loan processing capabilities and quickly disburse loans during the pandemic, SBA used an existing contract awarded to RER Solutions and its subcontractor Rocket Loans set aside for small businesses. SBA initially set a contract ceiling of $100 million and...

The Office of Inspector General (OIG) conducted this evaluation to assess the U.S. Small Business Administration’s (SBA) processes for reviewing Paycheck Protection Program (PPP) loans for eligibility and forgiveness.SBA’s online loan forgiveness platform used by lenders to submit forgiveness requests is adequate to support SBA’s loan review process. However, we found that for some loans, totaling $66.4 billion, SBA did not meet the 90-day statutory requirement to remit forgiveness payments to lenders. SBA did not meet the 90-day requirement for 98.2 percent of loans over $2 million. Not...

We evaluated the SBA’s handling of the grant to train small businesses on federal resources available in the wake of the Coronavirus Disease 2019 (COVID-19) pandemic. The Coronavirus Aid Relief and Economic Security (CARES) Act authorized funds up to $25 million for SBA to administer a grant to an association or associations representing resource partner centers to establish a single centralized hub for COVID-19 information.We found SBA did not ensure the grant recipient developed and implemented an effective marketing and outreach strategy to ensure the hub successfully achieved the...

We produced this Management Advisory to notify Small Business Administration (SBA) officials of serious concerns about potential improper payments in SBA’s Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loan (EIDL) program.Our review of Treasury’s analysis of processed COVID-19 EIDL and emergency EIDL grants from March to November 2020 revealed that SBA’s lack of adequate pre-award controls during this period of review led to 75,180 COVID-19 EIDLs totaling over $3.1 billion and 117,135 emergency EIDL grants totaling over $550 million being disbursed to potentially ineligible...

This report represents our current assessment of the U.S. Small Business Administration's programs and activities that pose significant risks, including those that are particularly vulnerable to fraud, waste, error, mismanagement, or inefficiencies. The Challenges are not presented in order of priority, except for the COVID 19 challenge, which we address first in this report. We also view the other challenges as critically important to SBA operations.

On March 13, 2020, the President of the United States declared that the COVID-19 pandemic was a national emergency. That same day, in accordance with section 1135(b) of the Social Security Act (the Act), the Secretary of HHS invoked his authority to waive or modify certain requirements of Titles XVIII, XIX, and XXI of the Act. To limit the spread of the virus, Federal, State and local governments urged individuals to stay at home and for individuals who test positive to quarantine, among other preventive measures. As a result, the usual and customary ways that many individuals obtained...

The Office of Inspector General examined Emergency EIDL grants to sole proprietors and independent contractors from March 29, 2020, until the funds were exhausted just 14 weeks later on July 10. We set out to determine whether the agency complied with its internal policy that set Emergency EIDL grants at $1,000 per employee up to the Coronavirus Aid, Relief, and Economic Security (CARES) Act mandated maximum amount of $10,000.Using SBA’s data, we found SBA provided $4.5 billion more in Emergency EIDL grants to sole proprietors and independent contractors than they were entitled to receive...

The United States currently faces a nationwide public health emergency because of the COVID-19 pandemic. Federal regulations, effective May 8, 2020, required nursing homes to report COVID-19 information, such as the number of confirmed COVID-19 cases among residents, at least weekly to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network. Each week, CDC aggregates the reported information and sends the data to the Centers for Medicare & Medicaid Services (CMS) for posting to the CMS website. These data are used to assist with national surveillance of...

SBA implemented or initiated action on all the OIG recommendations to strengthen internal controls related to the Paycheck Protection Program (PPP). The Economic Aid Act continued assistance under the PPP for small businesses financially affected by the ongoing coronavirus pandemic. We found SBA implemented the PPP in accordance with the Economic Aid Act with two exceptions. SBA did not 1) require an assessment of affiliation for faith-based organizations which contradicts its internal control procedures and 2) issue guidance regarding farm credit system institutions to ensure requirements...

We found that SBA established its May 2020 COVID-19 Reconstitution Plan in accordance with applicable federal guidance. We identified issues with the implementation of the reconstitution plan that should be addressed to help the agency safeguard its employees from contracting and spreading COVID-19 in the workplace.We found the agency did not follow occupancy procedures for advancing or reverting phases at its Washington, DC headquarters. SBA also did not implement exposure tracking protocols to ensure it consistently traced COVID-19 cases. We found the agency did not consistently notify its...

Hospitals that cannot control the spread of emerging infectious diseases within their facilities risk spreading a disease such as COVID-19 to patients and staff. OIG therefore developed a plan to assess the Centers for Medicare & Medicaid Services’ (CMS’s) controls related to hospital preparedness for emerging infectious diseases.The objective of this audit was to determine whether CMS designed and implemented effective internal controls related to hospital preparedness for emerging infectious diseases such as COVID-19.

The Office of Inspector General will conduct an evaluation of SBA’s awards made to Highlight Technologies LLC to meet emerging needs related to impacts of COVID-19. Our project is part of a series of reviews of contracts SBA awarded to support CARES Act and other COVID-19 related legislation programs. Our objective is to determine if SBA issued the blanket purchase agreement and contract modifications in accordance with federal laws, regulations, and internal guidance.

The Office of Inspector General Audits Division will perform an evaluation of the Small Business Administration’s implementation of the Restaurant Revitalization Fund. Our objectives are to determine if SBA designed the program to (1) align with the American Rescue Plan Act requirements including whether designated groups were prioritized and (2) minimize the risk of financial loss.

The Office of Inspector General (OIG) is issuing this Evaluation report to notify Small Business Administration (SBA) officials of significant matters regarding its handling of complaints of identity theft in the Coronavirus Disease 2019 (COVID-19) Economic Injury Disaster Loan (EIDL) program.We recommend the Administrator to direct the Associate Administrator for the Office of Disaster Assistance, the Chief Financial Officer for the Office of Performance Management and Chief Financial Officer, and the Associate Administrator for the Office of Capital Access to:1. Develop a process to maintain...

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 Office of Inspector General (OIG) is issuing this Management Alert regarding serious concerns with the control environment and the tracking of performance results in the Shuttered Venue Operators Grant (SVOG) program requiring immediate attention and action.SBA should take immediate action to reduce or eliminate risks by strengthening existing controls and implementing internal controls to address potential misuse of federal funds. Strong controls will ensure the SVOG program can effectively help eligible small business owners and entities that have suffered economic injury because of the...

This report found that SBA awarded the CARES Act entrepreneurial development cooperative agreements and grants in accordance with applicable federal laws, regulations, and guidance. We found program officials established performance goals and identified performance indicators. To more effectively ensure performance goals are achieved as intended, SBA should clearly define the performance goals and set performance targets.We recommended that SBA enforce standard operating procedures requiring defined performance goals and include performance targets in all future SBDC and WBC cooperative...

Inspection Notification: SBA’s Handling of Potentially Fraudulent Paycheck Protection Program Loans

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. 

SBA OIG reviewed PPP regulations and the Paycheck Protection Program and Health Care Enhancement Act, in addition to guidance published in SBA’s PPP Interim Final Rules and PPP Frequently Asked Questions.We determined SBA did not always have sufficient controls in place to detect and prevent duplicate PPP loans. As a result, lenders made more than one PPP loan disbursement to 4,260 borrowers with the same tax identification number and borrowers with the same business name and address. These disbursements totaled about $692 million for PPP loans approved from April 3 through August 9, 2020.We...

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.

The Health Resources and Services Administration (HRSA) is the primary Federal agency for improving health care to people who are geographically isolated and economically or medically vulnerable. HRSA should identify and mitigate risks related to awarding grants to health centers to minimize the potential misuse or loss of Federal funds. In spring 2020, HRSA awarded through three programs nearly $2 billion to approximately 1,380 health centers in response to the COVID-19 pandemic. To expedite distribution of this funding, HRSA did not require that health centers apply for grants. Instead, it made funds immediately available to health centers. Health centers had 30 days from the award release date to submit the information that is usually submitted, reviewed, and approved during the grant application process prior to a grantee receiving funding. We will determine whether HRSA had an effective process for identifying and monitoring high-risk health centers that received COVID-19 grants.

Telehealth is playing an important role during the public health emergency (PHE), and CMS is exploring how telehealth services can be expanded beyond the PHE to provide care for Medicare beneficiaries. Because of telehealth's changing role, we will conduct a series of audits of Medicare Part B telehealth services in two phases. Phase one audits will focus on making an early assessment of whether services such as evaluation and management, opioid use order, end-stage renal disease, and psychotherapy (Work Plan number W-00-21-35801) meet Medicare requirements. Phase two audits will include additional audits of Medicare Part B telehealth services related to distant and originating site locations, virtual check-in services, electronic visits, remote patient monitoring, use of telehealth technology, and annual wellness visits to determine whether Medicare requirements are met.

President Trump declared a national emergency in response to the COVID-19 pandemic, which allowed the Centers for Medicare & Medicaid Services (CMS) to take proactive steps to support the response to COVID-19 through the use of section 1135 waivers. By means of this authority, CMS waived certain requirements in order to expand Medicare telehealth benefits to health care professionals who were previously ineligible, including physical therapists, occupational therapists, speech language pathologists, and others. CMS also amended regulations to allow home health agencies to use telecommunications systems in conjunction with in-person visits. We will evaluate home health services provided by agencies during the COVID-19 public health emergency to determine which types of skilled services were furnished via telehealth, and whether those services were administered and billed in accordance with Medicare requirements. We will report as overpayments any services that were improperly billed. 
 

The Coronavirus Aid, Relief, and Economic Security (CARES) Act provides qualifying individuals with a recovery rebate (economic impact payment) of up to $1,200 (or $2,400 if married and filing jointly), plus up to $500 for each qualifying child. Congress added a number of exemptions concerning the economic impact payments within the CARES Act; however, it did not exempt child support debt. According to estimates, up to 10.5 million noncustodial parents are delinquent in their payment of child support and could have their economic impact payments intercepted. Based on the significant impact that the CARES Act will have on the collection of delinquent child support due to the intercept of economic impact payments, we determined that the focus of our audit would be to determine whether selected State(s) have policies and procedures in place to ensure that State child support programs collected and distributed delinquent child support under the Federal Tax Refund Offset program.

Accurate, complete, and appropriately detailed race and ethnicity data for Medicare beneficiaries are critical to identifying and mitigating health disparities. As racial and ethnic disparities have emerged among those impacted by COVID-19, the availability and quality of data on race and ethnicity has garnered greater attention and scrutiny. This study will describe the extent to which Medicare's race and ethnicity data for beneficiaries are complete and accurate. We will compare these data to data from other sources. We will also determine the extent to which the Medicare beneficiary race and ethnicity data align with Federal data standards.