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HHS OIG — Medicare Paid for HIV Drugs for Deceased Beneficiaries

October 31, 2014 Comments off

Medicare Paid for HIV Drugs for Deceased Beneficiaries
Source: U.S. Department of Health and Human Services, Office of Inspector General

WHY WE DID THIS STUDY
Under the Medicare Part D program, CMS contracts with private insurance companies, known as sponsors, to provide prescription drug coverage to beneficiaries who choose to enroll. OIG has had ongoing concerns about Medicare paying for drugs and services after a beneficiary has died.
Drugs that treat the human immunodeficiency virus (HIV) can be a target for fraud, waste, and abuse, primarily because they can be very expensive. Although this report focuses on HIV drugs, the issues raised are relevant to all Part D drugs.

HOW WE DID THIS STUDY
We based this study on an analysis of Prescription Drug Event (PDE) records for HIV drugs in 2012. Part D sponsors submit these records to CMS for each drug dispensed to beneficiaries enrolled in their plans. Each record contains information about the drug, beneficiary, pharmacy, and prescriber. We used the Beneficiary Enrollment Database, the Social Security Administration’s Death Master File, and Accurint’s Death Records to identify beneficiaries’ dates of death.

WHAT WE FOUND
Medicare paid for HIV drugs for over 150 deceased beneficiaries. CMS’s current practices allowed most of these payments to occur. Specifically, CMS has edits (i.e., systems processes) in place that reject PDE records for drugs with dates of service more than 32 days after death. CMS’s practices allow payment for drugs that do not meet Medicare Part D coverage requirements. Most of these drugs were dispensed by retail pharmacies.
This review looked only at HIV drugs, which account for one-quarter of one percent of all Part D drugs in 2012. However, our findings have implications for all drugs because Medicare processes PDE records for all drugs the same way. Considering the enormous number of Part D drugs, a change in practice would affect all Part D drugs and could result in significant cost savings for the program and for taxpayers.

WHAT WE RECOMMEND
We recommend that CMS change its practice of paying for drugs that have a date of service within 32 days after the beneficiary’s death. CMS should eliminate or-if necessary for administrative processing issues-shorten the window in which it accepts PDE records for drugs dispensed after a beneficiary’s death. Such a change would prevent inappropriate payments for drugs for deceased beneficiaries and lead to cost savings for the program and for taxpayers. CMS concurred with our recommendation.

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HHS OIG — Penetration Test of the Food and Drug Administration’s Computer Network

October 29, 2014 Comments off

Penetration Test of the Food and Drug Administration’s Computer Network
Source: U.S. Department of Health and Human Services, Office of Inspector General

We conducted an external penetration test of the Food and Drug Administration’s (FDA) network and information systems. Although we did not obtain unauthorized access to the FDA network, we identified the following issues: Web page input validation was inadequate, external systems did not enforce account lockout procedures, security assessments were not performed on all external servers, error messages revealed sensitive system information, and demonstration programs revealed sensitive information. These could have led to (1) the unauthorized disclosure or modification of FDA data or (2) FDA mission critical systems being made unavailable. We recommended that FDA implement necessary corrective actions to address the specific cybersecurity vulnerabilities that we identified during this audit.

Protecting Mail Covers in Law Enforcement Investigations

October 28, 2014 Comments off

Protecting Mail Covers in Law Enforcement Investigations
Source: U.S. Postal Service, Office of Inspector General

The outside of an envelope can be an effective tool in law enforcement investigations. In fiscal year 2013 alone, the Postal Inspection Service processed about 49,000 mail covers that were used to protect national security, locate fugitives, obtain evidence, or help locate stolen property.

But significant privacy issues govern the handling of mailpieces and the information on them. For that reason, the Postal Service and Postal Inspection Service must follow detailed procedures before allowing a mail cover.

The U.S. Postal Service Office of Inspector General recently reviewed 196 external mail covers and found some controls lacking. For example, 21 percent of the covers we examined were approved without the required written authorization and 13 percent were not adequately justified. Inadequate controls could impede investigations, raise public concerns about the privacy of the mail, and harm the Postal Service’s brand. The OIG made a number of recommendations to improve the management and integrity of the mail cover program.

DHS OIG — FEMA’s Logistics Supply Chain Management System May Not Be Effective During a Catastrophic Disaster

October 27, 2014 Comments off

FEMA’s Logistics Supply Chain Management System May Not Be Effective During a Catastrophic Disaster (PDF)
Source: U.S. Department of Homeland Security, Office of Inspector General

We audited the Federal Emergency Management Agency’s (FEMA) Logistics Supply Chain Management System program. According to FEMA, the Logistics Supply Chain Management System replaced its earlier logistics operations systems to automate and track distribution better and deliver emergency supplies more dependably. FEMA also intended for the system to help track supplies provided by partners in other Federal agencies; nongovernmental organizations; state, local, and tribal governments; and the private sector. Our audit objective was to determine whether FEMA’s Logistics Supply Chain Management System is able to support Federal logistics operations effectively in the event of a catastrophic disaster.

After spending about $247 million over 9 years, FEMA cannot be certain that its supply chain management system will be effective during a catastrophic disaster. FEMA estimated that the life cycle cost of the system would be about $556 million—$231 million more than the original life cycle cost estimate. According to FEMA, the Logistics Supply Chain Management System became fully operational in January 2013, which was about 19 months behind schedule. However, the system could not perform as originally planned. Specifically, it cannot interface with the logistics management systems of FEMA’s partners, nor does FEMA have realͲtime visibility over all supplies shipped by its partners. As of March 2014, the Logistics Supply Chain Management System still had not achieved full operational capability. We attribute these deficiencies to inadequate program management and oversight by the Department of Homeland Security (DHS) and FEMA. As a result, FEMA may not be able to efficiently and effectively aid survivors of catastrophic disaster.

Inspection of the Bureau of Diplomatic Security, High Threat Programs Directorate

October 16, 2014 Comments off

Inspection of the Bureau of Diplomatic Security, High Threat Programs Directorate (PDF)
Source: U.S. Department of State, Office of Inspector General

Key Findings

+ The establishment of the Bureau of Diplomatic Security, High Threat Programs directorate in 2013 enabled the Bureau of Diplomatic Security to enhance its focus on the security needs of overseas posts most susceptible to risk and threat.

+ The High Threat Programs directorate suffers from significant staffing gaps and position shortages. In order to continue to meet its goals, the Department needs to staff the directorate fully.

Homeland Security OIG — Improvements Continue at Detention Centers

October 8, 2014 Comments off

Improvements Continue at Detention Centers (PDF)
Source: U.S. Department of Homeland Security, Office of Inspector General

The latest in a series of spot inspections by the Office of Inspector General (OIG), Department of Homeland Security (DHS), found overall improvement, several recurring problems and declining populations at detention facilities for unaccompanied alien children (UAC) operated by Customs and Border Protection (CBP).

+ Full Report (PDF)

DHS OIG — Flawed FEMA System Could Hamper Disaster Relief

October 7, 2014 Comments off

Flawed FEMA System Could Hamper Disaster Relief (PDF)
Source: U.S. Department of Homeland Security, Office of Inspector General

After spending more than $247 million on a high-tech system, the Federal Emergency Management Agency (FEMA) may still not be able to efficiently deliver emergency supplies to survivors of a catastrophic disaster, an Office of Inspector General (OIG) audit has found.

OIG Report 14-151, “FEMA’s Logistics Supply Chain Management System May Not Be Effective During a Catastrophic Disaster,” found the system, developed over nine years, cannot interface with those of its partners and suppliers, making it difficult to track and locate emergency supplies. The report also noted that FEMA does not have enough trained employees to efficiently operate the system.

+ Full Report (PDF)

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