Appendix F - Management Report on Final Action
October 1, 2003 - September 30, 2004
Background
The Inspector General Act Amendments of 1988 (P.L. 100-504) require Departments and agencies to report to Congress on the actions they have taken and the amount of funds recovered or saved in response to the Office of Inspector General's (OIG) audit recommendations. This annual management report provides the status of OIG reports in the Department and summarizes the results of actions taken to implement OIG audit recommendations during the reporting period.
Departmental Findings
For the fiscal year covered by this report, the Department accomplished the following:
- Initiated action to recover $755 million through collection, offset, or other means (see Table I);
- Completed action to recover $518 million through collection, offset, or other means (see
Table I);
- Initiated action to put to better use $1 billion (see Table II); and
- Completed action that over time will put to better use $1 billion (see Table II).
At the end of this period there are 287 reports over 1 year old with uncollected balances or unimplemented monetary findings. The reasons these reports are still pending are found in the notes to the tables.
|
The
HHS Process
|
|
Four Key Elements
to the HHS Audit Resolution and Follow-up
Process
|
-
The HHS Agencies have a lead responsibility
for implementation and follow-up on most OIG and
independent auditor recommendations;
-
The Assistant Secretary for Budget,
Technology, and Finance establishes policy and monitors
HHS Agencies’ compliance with audit follow-up
requirements;
-
The audit resolution process includes the
ability to appeal disallowances administratively under
such programs as Head Start, Foster Care and Medicaid
pursuant to the Board’s regulations in 45 C.F.R.
Part 16; and
-
If necessary, the Assistant Secretary for
Budget, Technology, and Finance or the Deputy Secretary
resolves conflicts between the HHS Agencies and the
OIG.
|
Departmental Conflict Resolution
In the event that the HHS agencies and OIG staff cannot resolve differences on specific report recommendations, a conflict resolution mechanism is available. During FY 2004, there were no disagreements requiring the convening of the Conflict Resolution Council.
Status of Audits in the Department
In general, HHS Agencies follow up on OIG recommendations effectively and within regulatory time limits. The HHS Agencies usually reach a management decision within the 6-month period that is prescribed by P.L. 100-504 and OMB Circular A-50, Audit Followup. For the most part, they also complete their final actions on OIG reports, including collecting disallowed costs and carrying out corrective action plans, within a reasonable amount of time. However, the Department continues to monitor this area to improve procedures and ensure compliance with corrective action plans.
Report on Final Action Tables
The following tables summarize the Department's actions in collecting disallowed costs and implementing recommendations to put funds to better use. Disallowed costs are those costs that are challenged because of a violation of law, regulation, grant term or condition, etc. Funds to be put to better use relate to those costs associated with cost avoidances, budget savings, etc. The tables are set up according to the requirements of Section 106(b) of P.L. 100-504.
|
TABLE
I
Management Action on Costs Disallowed in OIG
Reports
As of
September 30, 2004
(in thousands)
|
|
|
Number
|
Disallowed
Costs
|
|
A. Reports for which final action had not been
taken by the commencement of the reporting period.
See Note 1.
|
435
|
$838,943
|
|
B. Reports on which management decisions were
made during the reporting period. See Note 2.
|
322
|
$754,809
|
|
Subtotal
(A+B)
|
757
|
$1,593,752
|
|
C. Reports for which final action was taken
during the reporting period:
-
The dollar value of disallowed costs that
were recovered through collection, offset, property in
lieu of cash, or otherwise.
-
The dollar value of disallowed costs that
were written off by management.
|
370
2
|
$518,345
$175
|
|
Subtotal
(i+ii)
|
372
|
$518,520
|
|
D. Reports for which no final action has been
taken by the end of the reporting period. See Note
3.
|
385
|
$1,075,232
|
|
Notes:
-
Includes adjustments of amended
disallowance and disallowance excluded from the previous
reporting period.
-
Represents the amount of management concurrence with the OIG’s
recommendations. For this fiscal year, the
OIG’s reconciliation with the HHS Agencies showed a
variance that represents the two organizations having
different cut-off dates.
-
Includes the list of audits over 1 year old with outstanding balances to be
collected. Includes audits under administrative or
judicial appeal, under current collection schedule, and
legislatively uncollectible.
|
|
TABLE II Management Action on OIG Reports
with Recommendations That Funds Be Put
to Better Use
As of September 30,
2004
(in thousands)
|
|
|
Number
|
Disallowed
Costs
|
|
A. Reports for which final action had not been
taken by the commencement of the reporting period.
See Note 1.
|
12
|
$56,420,817
|
|
B. Reports on which management decisions were
made during the reporting period.
|
12
|
$1,331,208
|
|
Subtotal
(A+B)
|
24
|
$57,752,025
|
|
C. Reports for which final action was taken
during the reporting period:
-
The dollar value of recommendations that
were actually completed based on management action or
legislative action.
-
The dollar value of recommendations
that management has subsequently concluded should not or
could not be implemented or completed.
|
11
0
|
$1,321,165
$0
|
|
Subtotal
(i+ii)
|
11
|
$1,321,165
|
|
D. Reports for which no final action has been
taken by the end of the reporting period. See Note
2.
|
13
|
$56,430,860
|
|
Notes:
-
Includes adjustments of amended
disallowances and disallowances excluded from the previous
reporting period.
-
Includes the nine reports shown on the
following page with recommendations to put funds to better
use that were pending for more than 1 year. These
reports involve major policy questions as well as
legislative remedies that are difficult and time consuming
to resolve.
|
|
Reports Containing Recommendations to
Put Funds
to Better Use Pending More Than 1
Year
As of September 30, 2004
|
|
Audit
Number
|
Auditee
|
Date
Issued
|
Amount
|
Explanations
|
|
OEI-12-92-00460
|
Inappropriate
Payments for Total Parenteral Nutrition (TPN)
(ES#921222-1330)
|
Jun-93
|
$69,000,000
|
CMS currently is
determining the actual amount of the savings.
|
|
A-06-92-00043
|
BC/BS of Texas, Inc.
-- GME Costs
|
Mar-94
|
$4,078,960
|
Corrective action
cannot be implemented pending the resolution of an
objection lodged by the providers' legal counsel with
the OIG and the Office of General Counsel.
|
|
A-04-95-02110
|
SC BC (Hospice of
Lake & Sumter, Inc.) – ORT
|
Nov-96
|
$2,500,000
|
CMS is reassessing
whether seeking the identified OIG hospice overpayment is
the appropriate action to take.
|
|
A-06-95-00095
|
Palmetto Gov. Ben.
Admin. (Fam. Hospice/Dallas)-ORT
|
Jan-97
|
$69,648
|
CMS is reassessing
whether seeking the identified OIG hospice overpayment is
the appropriate action to take.
|
|
A-05-95-00060
|
WI Department of
Health and Social Services
|
Feb-97
|
$2,400,000
|
The State of
Wisconsin plans to establish a work group to meet and
review HMO financial data related to Medicaid HMOs to
determine the actual amount of the savings.
|
|
OEI-03-99-00200
|
Medicare Payouts for
Services After Death
|
Mar-97
|
$4,800,000
|
CMS is in the
process of determining the amount of savings.
|
|
A-06-01-00053
|
Medicaid
Pharmacy
|
May-02
|
$470,000,000
|
Actual acquisition
costs of generic prescription drug products.
|
|
A-09-01-00109
|
Medicare Part B Fee
Schedule Amounts
|
Dec-02
|
$171,500,000
|
CMS is in the
process of determining the amount of savings.
|
|
A-03-00-00216
|
Medicaid Enhanced
Payments
|
Nov-01
|
$55,497,000,000
|
Review to local
public providers and the use of intergovernmental
transfers.
|
|
Total
9 Reports from CMS
|
$56,221,348,608
|
|
|
HHS
Audit Reports Over 1 Year Old With Outstanding Balances To
Be Collected
As
of September 30, 2004
|
|
HHS
Agency
|
Audit Report #
|
Auditee
|
Issue Date
|
Amount
|
Note
|
|
ACF
|
02-00-64555
|
Utica-HS
|
Oct-01
|
$166,880
|
6
|
|
ACF
|
02-02-69503
|
Puerto
Rico
|
Feb-03
|
$507,667
|
25
|
|
ACF
|
02-02-71356
|
2nd St
Youth Ctr.
|
Feb-03
|
$15,034
|
1
|
|
ACF
|
02-91-14405
|
Bedford Stuyvesanto/O
|
Mar-02
|
$34,593
|
3
|
|
ACF
|
02-97-47637
|
Puerto
Rico IV-B
|
Sep-97
|
$9,703
|
25
|
|
ACF
|
02-99-02005
|
Puerto
Rico
|
Oct-02
|
$1,214,299
|
4
|
|
ACF
|
02-99-58335
|
Puerto
Rico
|
Mar-99
|
$5,400
|
25
|
|
ACF
|
03-01-00510
|
Council Southern MT
|
Nov-01
|
$11,635
|
6
|
|
ACF
|
03-02-00550
|
Central Piedmont Act
|
Jun-03
|
$41,106
|
6
|
|
ACF
|
03-02-72227
|
State
of VA
|
Jan-01
|
$1,100,000
|
1
|
|
ACF
|
03-03-73256
|
Lawrence Cty HS, Inc
|
Jun-03
|
$148,663
|
6
|
|
ACF
|
03-03-73829
|
Preschool Dev Prog
|
Jul-03
|
$961,497
|
1
|
|
ACF
|
03-03-74041
|
Child
Advocates of Blair
|
Jun-03
|
$110,563
|
25
|
|
ACF
|
03-03-74937
|
Preschool Dev Prog
|
Sep-03
|
$448,772
|
6
|
|
ACF
|
03-97-43787
|
VA/CCDBG
|
Jun-97
|
$937,769
|
25
|
|
ACF
|
03-97-47731
|
State
of DE
|
Sep-97
|
$11,880
|
25
|
|
ACF
|
03-99-03305
|
Research Assessment State of MD
|
Jul-00
|
$4,453,336
|
6
|
|
ACF
|
04-00-60897
|
State
of FL
|
Nov-00
|
$33,397
|
25
|
|
ACF
|
04-00-64861
|
State
of NC
|
Mar-01
|
$357,591
|
6
|
|
ACF
|
04-00-66032
|
State
of FL
|
Jan-01
|
$41,989
|
25
|
|
ACF
|
04-01-68839
|
State
of FL
|
Apr-02
|
$155,973
|
25
|
|
ACF
|
04-01-68839
|
State
of FL
|
Apr-02
|
$7,519
|
25
|
|
ACF
|
04-91-06594
|
Mountain Valley/HS
|
Sep-92
|
$196,213
|
2
|
|
ACF
|
04-92-17186
|
Mountain Valley/HS
|
Sep-92
|
$203,420
|
2
|
|
ACF
|
04-94-30737
|
Mountain Valley/HS
|
Jul-94
|
$39,095
|
2
|
|
ACF
|
04-96-00105
|
Delta
Foundation
|
Apr-99
|
$1,225,291
|
4
|
|
ACF
|
04-96-00107
|
Harambee Child Level
|
Aug-99
|
$124,811
|
6
|
|
ACF
|
04-97-47475
|
Wash
Cty Opport Inc.
|
Nov-97
|
$173,151
|
4
|
|
ACF
|
04-99-56945
|
Quitman Cty Dev Org Inc
|
Jun-02
|
$6,375
|
6
|
|
ACF
|
04-99-59501
|
Chapel
Hill Carrboro
|
Jan-02
|
$11,256
|
6
|
|
ACF
|
05-01-67360
|
MI
Family Independence Agency
|
Jul-01
|
$150,000
|
25
|
|
ACF
|
05-02-70977
|
Nottawaseppi
|
Nov-02
|
$671
|
6
|
|
ACF
|
05-03-73080
|
Genesee Cty Comm Action
|
May-03
|
$14,511
|
25
|
|
ACF
|
05-03-73766
|
Family
Dev Service
|
Sep-03
|
$20,679
|
25
|
|
ACF
|
05-97-48402
|
Montgomery Co CAA
|
Nov-97
|
$79,374
|
2
|
|
ACF
|
05-98-00010
|
State
WI
|
Feb-00
|
$3,318,857
|
25
|
|
ACF
|
06-00-62531
|
NA
Five Sandoval Indian Pueblos Inc.
|
Oct-00
|
$13,958
|
4
|
|
ACF
|
06-02-70441
|
Five
Sandoval Indian Tribe
|
Apr-03
|
$67,998
|
6
|
|
ACF
|
06-02-72487
|
Kaw
National of OK
|
May-03
|
$647
|
6
|
|
ACF
|
06-03-73575
|
Hidalgo Cty TX
|
Jul-03
|
$543,541
|
6
|
|
ACF
|
06-90-00052
|
Mexican Amer/Discret
|
Apr-92
|
$74,646
|
3
|
|
ACF
|
06-97-47657
|
Five
Sandoval
|
Nov-99
|
$46,660
|
6
|
|
ACF
|
06-97-47730
|
Tri-County Head Start
|
Dec-97
|
$2,451
|
6
|
|
ACF
|
06-97-48284
|
E
Texas Family Srv
|
Nov-98
|
$9,130
|
6
|
|
ACF
|
06-97-48531
|
TX
DHS
|
Jan-99
|
$11,209
|
25
|
|
ACF
|
07-02-00138
|
State
of NE
|
Sep-03
|
$11,681,442
|
1
|
|
ACF
|
07-02-72037
|
State
of KS
|
Oct-01
|
$57,236
|
1
|
|
ACF
|
07-98-50741
|
Citizens Housing
|
Dec-99
|
$2,678
|
6
|
|
ACF
|
08-97-43975
|
Oglala
Sioux Tribe
|
May-99
|
$6,494
|
6
|
|
ACF
|
08-99-57703
|
Connejos-Costil
|
Oct-99
|
$21,145
|
6
|
|
ACF
|
08-99-59825
|
Crow
Creek Sioux Tribe
|
Jan-00
|
$26,660
|
6
|
|
ACF
|
08-99-59907
|
Crow
Creek Sioux Tribe
|
Aug-00
|
$344,504
|
6
|
|
ACF
|
09-00-63951
|
Tohono
O Odham Nation
|
May-01
|
$164,947
|
4
|
|
ACF
|
09-90-56270
|
Rinco
San Luiseno Band
|
Apr-01
|
$49,460
|
6
|
|
ACF
|
09-93-00106
|
CA
Dept. of Social Svcs.
|
May-97
|
$29,269
|
25
|
|
ACF
|
09-93-23668
|
Center
of ED/HS
|
Nov-93
|
$12,070
|
25
|
|
ACF
|
09-95-00091
|
Walter
McDonald Asso.
|
Jul-99
|
$23,553
|
4
|
|
ACF
|
09-96-40113
|
Protective & Adv Mariana
|
Apr-98
|
$80,574
|
6
|
|
ACF
|
09-96-40114
|
Protective & Adv Mariana
|
Apr-98
|
$36,988
|
6
|
|
ACF
|
09-96-40115
|
Protective & Adv Mariana
|
Apr-98
|
$56,344
|
6
|
|
ACF
|
10-00-58628
|
Kuigpagmiut, In.
|
Apr-00
|
$18,119
|
6
|
|
ACF
|
10-01-66783
|
Native
Village of Mekoryuk
|
Apr-01
|
$15,883
|
4
|
|
ACF
|
10-03-72484
|
Maniilaq Manpower, Incak
|
Jul-03
|
$44,498
|
6
|
|
ACF
|
10-98-00008
|
Siletz
River Co.
|
Apr-00
|
$27,316
|
6
|
|
|
|
Total for ACF
|
|
$29,808,390
|
|
|
CDC
|
01-00-62266
|
State
of ME
|
Feb-00
|
$138,782
|
5
|
|
CDC
|
01-00-66460
|
State
of ME
|
Jan-03
|
$363,364
|
5
|
|
CDC
|
01-02-70271
|
State
of ME
|
Apr-03
|
$561,697
|
5
|
|
CDC
|
01-02-71527
|
State
of MA
|
Apr-02
|
$29,260
|
5
|
|
CDC
|
01-02-73084
|
State
of ME
|
Sep-02
|
$188,524
|
5
|
|
CDC
|
01-96-37165
|
Haitian American Public Health
Initiative
|
Mar-97
|
$20,209
|
5
|
|
CDC
|
03-01-66421
|
American Assoc. of Community
Colleges
|
Nov-00
|
$7,474
|
5
|
|
CDC
|
03-02-72715
|
DC
Dept. of Health
|
Jul-03
|
$7,851
|
5
|
|
CDC
|
03-03-72847
|
DC
Dept. of Health
|
Oct-02
|
$12,850
|
5
|
|
CDC
|
03-98-50835
|
Nat'l Organ. of Black County
Officials
|
Jan-99
|
$19,385
|
5
|
|
CDC
|
03-98-50836
|
Nat'l Organ. of Black County
Officials
|
Jan-99
|
$27,140
|
5
|
|
CDC
|
03-98-50837
|
Nat'l Organ. of Black County
Officials
|
Mar-99
|
$1,078
|
5
|
|
CDC
|
03-98-51634
|
City
of Philadelphia, PA.
|
Jun-98
|
$93,690
|
5
|
|
CDC
|
03-99-56842
|
Nat'l Assoc. for Equal Opport. in
Higher Ed.
|
Feb-01
|
$33,585
|
5
|
|
CDC
|
04-00-61897
|
American Cancer Society
|
Mar-01
|
$28,654
|
5
|
|
CDC
|
04-00-65030
|
State
of SC
|
Jul-00
|
$688,633
|
1
|
|
CDC
|
04-02-72213
|
State
of FL
|
Jun-02
|
$28,612
|
5
|
|
CDC
|
04-98-51239
|
State
of AL Child Care & Dev. Fund Mand.
|
Sep-98
|
$227,200
|
5
|
|
CDC
|
05-03-73921
|
DC
Dept. of Health
|
Nov-02
|
$13,317
|
5
|
|
CDC
|
06-01-68128
|
City
of Houston, TX
|
Feb-01
|
$56,340
|
5
|
|
CDC
|
06-02-70732
|
US-Mexico Border Health
Association
|
Jan-02
|
$23,483
|
5
|
|
CDC
|
06-98-54189
|
City
of Houston, TX
|
Jul-98
|
$12,096
|
5
|
|
CDC
|
09-96-41444
|
Immigrant Center
|
Mar-97
|
$2,495
|
5
|
|
CDC
|
10-98-53018
|
Self
Enhancement, Inc.
|
May-00
|
$3,452
|
5
|
|
CDC
|
10-98-53162
|
People
of Color Against AIDS Network
|
Sep-00
|
$8,289
|
5
|
|
|
|
Total for CDC
|
|
$2,597,460
|
|
|
CMS
|
01-01-00502
|
Ambulance & Radiology Serv
|
Oct-02
|
$51,000,000
|
5
|
|
CMS
|
01-01-00542
|
Associated Hospital Serv
|
Dec-02
|
$518,981
|
5
|
|
CMS
|
01-89-00518
|
Blue Shield of
MA
|
Oct-90
|
$216,053
|
11
|
|
CMS
|
01-90-00500
|
Blue Cross of
MA
|
Sep-90
|
$7,048,076
|
4
|
|
CMS
|
01-91-00508
|
Aetna Life-Parts
A&B Adm.
|
Jan-92
|
$223,655
|
12
|
|
CMS
|
01-92-00517
|
Blue Cross of
M.
|
Apr-93
|
$160,122
|
5
|
|
CMS
|
01-92-00523
|
BC/BS of MA -Part B
Lab Tests
|
Jan-94
|
$2,250,000
|
26
|
|
CMS
|
01-93-00512
|
BC/BS of MA-Lab
Test
|
Jul-94
|
$426,817
|
26
|
|
CMS
|
01-94-00510
|
BC/BS of MS - ADM
costs
|
Apr-95
|
$130,299
|
5
|
|
CMS
|
01-95-00503
|
G/A & Capitol
McLean Ho- Adm Costs
|
Aug-95
|
$186,190
|
5
|
|
CMS
|
01-96-00513
|
Separately Billable
ESRDL Lab Tests
|
Dec-96
|
$6,300,000
|
5
|
|
CMS
|
01-96-00519
|
Nat'l Medical
Care ESRD
|
Sep-97
|
$4,319,361
|
7
|
|
CMS
|
01-96-00527
|
Clinical Lab Tests-
Hosp. Outpatient Labs
|
Dec-00
|
$43,632,767
|
5
|
|
CMS
|
01-98-00512
|
CT BC/BS
Noncompliance
|
Jun-98
|
$3,264
|
5
|
|
CMS
|
01-99-00501
|
Waterbury
Hospital
|
Oct-99
|
$103,588
|
5
|
|
CMS
|
01-99-00518
|
Danbury
Hospital
|
May-00
|
$62,104
|
5
|
|
CMS
|
01-99-00521
|
Hematology
Indices
|
Sep-00
|
$14,000,000
|
5
|
|
CMS
|
01-99-00522
|
Medicare Clinical
Lab Tests
|
Oct-00
|
$31,200,000
|
5
|
|
CMS
|
01-99-00523
|
United HealthCare
Ins.
|
Aug-00
|
$19,282
|
5
|
|
CMS
|
02-00-01023
|
N.
Shore Long Island Jewish Hlth System
|
Jul-02
|
$319,130
|
5
|
|
CMS
|
02-00-01032
|
St.
Barnabas Hosp
|
Jul-02
|
$205,100
|
5
|
|
CMS
|
02-00-01048
|
Triple
S Inc.
|
Dec-01
|
$298,693
|
5
|
|
CMS
|
02-86-62015
|
Empire BC/BS
|
Mar-88
|
$1,277,575
|
9
|
|
CMS
|
02-86-62016
|
Empire BC/BS
|
Aug-88
|
$3,027,672
|
8
|
|
CMS
|
02-91-01022
|
Prudential
Ins.-ADM
|
Mar-92
|
$6,837,167
|
14
|
|
CMS
|
02-92-01004
|
NJ DHS - Credit
Balances for Eight Hosp
|
Sep-93
|
$89,839
|
5
|
|
CMS
|
02-96-01034
|
Staff Blders. Home
Health Inc. Buffalo-ORT
|
Jan-98
|
$2,046,576
|
5
|
|
CMS
|
02-97-01026
|
Eddy VNA of the
Capital Region
|
Nov-99
|
$11,336,867
|
5
|
|
CMS
|
02-97-01041
|
Personal Care Svc.,
Westchester Cty. NY
|
Apr-99
|
$687,418
|
5
|
|
CMS
|
02-99-01026
|
South Jersey Rehab
Associates, Inc.
|
Nov-00
|
$259,068
|
5
|
|
CMS
|
03-01-00005
|
Veritus, Inc.
|
Oct-01
|
$131,071
|
5
|
|
CMS
|
03-92-00150
|
Elmira Jeffries
MNH
|
Jan-94
|
$164,188
|
22
|
|
CMS
|
03-92-00201
|
Commonwealth of
VA
|
Jan-93
|
$205,177
|
14
|
|
CMS
|
03-92-00602
|
PA DPW - Upper
limit
|
Sep-94
|
$230,520
|
5
|
|
CMS
|
03-93-00013
|
Omega Med.
Lab.
|
Nov-93
|
$1,102
|
5
|
|
CMS
|
03-93-00025
|
PBS - Lab Fee
Schedules
|
Sep-95
|
$953,377
|
5
|
|
CMS
|
03-95-38380
|
Commonwealth of
VA
|
Mar-96
|
$68,333
|
5
|
|
CMS
|
03-99-00012
|
John
Hopkins Bayview Medical Ctr
|
Jun-02
|
$957,458
|
5
|
|
CMS
|
04-00-06005
|
Univ
of Al at Birmingham Hospital
|
Apr-02
|
$5,428,248
|
5
|
|
CMS
|
04-00-61448
|
State of GA
(OGM)
|
Feb-00
|
$1,032,355
|
24
|
|
CMS
|
04-00-61620
|
State
of NC
|
Nov-01
|
$57,097
|
5
|
|
CMS
|
04-00-61627
|
State of TN
|
Mar-00
|
$359,907
|
24
|
|
CMS
|
04-01-68698
|
State
of MS
|
Mar-02
|
$3,560,760
|
5
|
|
CMS
|
04-02-02016
|
Pitt County Memorial
Hospital
|
Jan-03
|
$49,696
|
14
|
|
CMS
|
04-02-72659
|
State
of GA
|
Sep-02
|
$142,363
|
5
|
|
CMS
|
04-94-01096
|
Humana Medical
Plans, Inc.
|
Apr-95
|
$624,048
|
5
|
|
CMS
|
04-95-01104
|
American Health
Care-ORT
|
Jan-97
|
$1,200,000
|
5
|
|
CMS
|
04-95-02110
|
SC BC (Hospice of
Lake and Sumter, Inc.) ORT
|
Apr-97
|
$4,000,000
|
5
|
|
CMS
|
04-95-02111
|
B/C of SC (Hospice
of FL Suncoast, Inc.)
|
Mar-97
|
$14,800,000
|
5
|
|
CMS
|
04-95-33005
|
State of MS
(OGM)
|
Aug-95
|
$63,140
|
12
|
|
CMS
|
04-95-33088
|
State of NC
(OGM)
|
Sep-96
|
$2,642
|
12
|
|
CMS
|
04-95-38310
|
State of MS
(OGM)
|
Mar-96
|
$9,069,408
|
22
|
|
CMS
|
04-96-01125
|
Aetna-
Rosemont Health Care Ctr
|
Jan-02
|
$55,306
|
5
|
|
CMS
|
04-96-01129
|
CA BC
- ORT SNF of Washington Manor
|
Jan-02
|
$284,378
|
5
|
|
CMS
|
04-96-01131
|
Aetna (Health Svcs.
Of Green Briar)-ORT
|
Nov-97
|
$202,780
|
5
|
|
CMS
|
04-96-01134
|
Aetna
Colonnade Med. Ctr - ORT
|
Jan-02
|
$385,338
|
5
|
|
CMS
|
04-96-01135
|
Aetna
Washington Manor ORT
|
Jan-02
|
$220,483
|
5
|
|
CMS
|
04-96-01136
|
Aetna
Savanna Cay Manor -ORT
|
Jan-02
|
$354,537
|
5
|
|
CMS
|
04-96-01148
|
Aetna Life Insur.
Co.
|
Nov-97
|
$148,955
|
5
|
|
CMS
|
04-96-02122
|
Blue Cross of
GA
|
Oct-98
|
$791,327
|
6
|
|
CMS
|
04-97-01164
|
1996 ACR Proposal
for FL MCP
|
Jan-00
|
$9,660,000
|
5
|
|
CMS
|
04-97-01168
|
FL Agency for Health
Care Administration
|
Dec-99
|
$8,885,855
|
14
|
|
CMS
|
04-97-02130
|
Mutual of
Omaha
|
Apr-99
|
$1,709,245
|
5
|
|
CMS
|
04-97-02138
|
Mutual of
Omaha
|
Apr-99
|
$2,382,527
|
5
|
|
CMS
|
04-98-01184
|
Homebound Medical
Care, Inc.
|
Jun-00
|
$1,860,760
|
5
|
|
CMS
|
04-99-01193
|
Six State Review of
O/P Rehab. Facilities
|
Jun-00
|
$74,067,804
|
5
|
|
CMS
|
04-99-01195
|
Medicare Home Health
Services in FL
|
Mar-01
|
$57,022
|
5
|
|
CMS
|
04-99-55388
|
State of NC
(OGM)
|
Jun-99
|
$367,984
|
5
|
|
CMS
|
04-99-55479
|
Commonwealth of KY
(OGM)
|
Mar-99
|
$316,997
|
5
|
|
CMS
|
04-99-55653
|
State of TN
(OGM)
|
Nov-99
|
$309,448
|
5
|
|
CMS
|
04-99-59921
|
State of KY
(OGM)
|
Oct-99
|
$184,633
|
5
|
|
CMS
|
05-02-72686
|
Ohio Dept of Job and
Family Services
|
Jul-02
|
$6,323
|
5
|
|
CMS
|
05-02-72686
|
State's Home
Care Program
|
Aug-02
|
$20,572
|
5
|
|
CMS
|
05-03-74058
|
Bellefaire Jewish
Children's Bureau
|
Nov-02
|
$11,410
|
5
|
|
CMS
|
05-90-00013
|
BC/BS of MI -
Admin
|
Dec-90
|
$2,413,388
|
10
|
|
CMS
|
05-97-00029
|
Office of Medicaid
Policy and Planning - IN
|
Mar-99
|
$2,000,000
|
5
|
|
CMS
|
06-01-00039
|
TX
Hlth & Human Serv Commission
|
Jun-02
|
$40,070
|
5
|
|
CMS
|
06-01-00077
|
OK Medicaid School
Based Services
|
Oct-02
|
$1,902,390
|
25
|
|
CMS
|
06-01-68876
|
State
of LA -OGM
|
Jun-02
|
$48,414
|
5
|
|
CMS
|
06-02-72136
|
State of LA
|
Jun-02
|
$64,870
|
5
|
|
CMS
|
06-92-00043
|
BC/BS of TX - GME
Costs
|
Mar-94
|
$4,252,743
|
23
|
|
CMS
|
06-95-00095
|
Palmetto Gov. (Fam
Hospice/Dallas)
|
Apr-97
|
$871,306
|
22
|
|
CMS
|
06-96-00027
|
Palmetto Gov. (VNA
of TX Hospice)
|
Apr-97
|
$1,156,341
|
22
|
|
CMS
|
06-97-00034
|
Risk Base Health
Maint.
|
Jun-99
|
$55,895
|
5
|
|
CMS
|
06-99-00058
|
State of LA
(OGM)
|
Jun-00
|
$5,290,000
|
5
|
|
CMS
|
06-99-56489
|
State of LA
(OGM)
|
Aug-99
|
$368,258
|
5
|
|
CMS
|
07-00-65149
|
NE Health &
Human Serv Nursing Facility
|
Sep-00
|
$1,450,104
|
5
|
|
CMS
|
07-01-02616
|
Mutual of
Omaha
|
Aug-01
|
$11,336,867
|
5
|
|
CMS
|
07-02-03017
|
BC-BS of NC
|
Feb-03
|
$5,305,655
|
18
|
|
CMS
|
07-03-02654
|
Ambulatory Surgical
Centers
|
Dec-02
|
$230,545
|
5
|
|
CMS
|
07-03-02655
|
Ambulatory Surgical
Centers
|
Dec-02
|
$92,393
|
5
|
|
CMS
|
07-03-02657
|
Ambulatory Surgical
Centers
|
Dec-02
|
$26,785
|
5
|
|
CMS
|
07-03-02659
|
Ambulatory Surgical
Centers
|
Nov-02
|
$2,655
|
5
|
|
CMS
|
07-03-02663
|
Ambulatory Surgical
Centers
|
Jan-03
|
$9,338
|
5
|
|
CMS
|
07-91-00471
|
BC/BS of MI -
Pension Seg.
|
Dec-92
|
$5,021,873
|
10
|
|
CMS
|
07-91-00473
|
BC/BS of FL,
Inc.-Pension Seg.
|
Aug-93
|
$4,755,565
|
13
|
|
CMS
|
07-92-00525
|
BC/BS of MI -Pension
Costs
|
Dec-92
|
$2,135,884
|
10
|
|
CMS
|
07-92-00578
|
BC/BS of TX -
Unfunded Pension Costs
|
Oct-92
|
$6,244,637
|
13
|
|
CMS
|
07-92-00585
|
BS of CA - Pension
Costs
|
Feb-94
|
$2,973,504
|
5
|
|
CMS
|
07-92-00604
|
WVA BC/BS Term
Pension
|
Jan-93
|
$617,644
|
17
|
|
CMS
|
07-92-00608
|
BC/BS of
Missouri
|
Jun-93
|
$960,615
|
15
|
|
CMS
|
07-93-00634
|
Travelers - Pension
Seg.
|
Oct-93
|
$1,026,460
|
18
|
|
CMS
|
07-93-00665
|
Travelers Ins.-
Pension Costs
|
Oct-93
|
$1,218,963
|
5
|
|
CMS
|
07-93-00680
|
BC/BS of NC -
Unfunded Pension Costs
|
Oct-94
|
$293,629
|
21
|
|
CMS
|
07-93-00709
|
BC/BS of CT -
Pension Seg.
|
Apr-94
|
$119,472
|
19
|
|
CMS
|
07-93-00710
|
BC/BS of CT -
Pension Costs
|
Mar-93
|
$237,392
|
19
|
|
CMS
|
07-93-00713
|
PA BS - Pension
Costs
|
Jun-95
|
$5,490,995
|
5
|
|
CMS
|
07-94-00744
|
IASD Health Svcs.
Corp. - Pension Seg.
|
Sep-94
|
$3,079,484
|
20
|
|
CMS
|
07-94-00745
|
IASD Hlth Svcs.
Corp. - Unfunded Pen.
|
May-94
|
$574,804
|
20
|
|
CMS
|
07-94-00746
|
IASD Health Svcs.
Corp. - Pension Seg.
|
May-94
|
$842,979
|
20
|
|
CMS
|
07-94-00747
|
IASD Hlth Svcs.
Corp. - Unfunded Pen.
|
May-94
|
$10,331
|
20
|
|
CMS
|
07-94-00762
|
Health Care Svcs.
Corp - Unfunded Pen.
|
Jul-94
|
$1,233,337
|
10
|
|
CMS
|
07-94-00763
|
Health Care Svcs.
Corp.- Pension Seg.
|
Aug-94
|
$1,055,458
|
10
|
|
CMS
|
07-94-00768
|
BC/BS of SC -
Pension Costs
|
Sep-94
|
$840,493
|
13
|
|
CMS
|
07-94-00769
|
BC/BS of SC -
Pension Costs
|
Sep-94
|
$329,001
|
19
|
|
CMS
|
07-94-00770
|
BC/BS of SC-
Unfunded Pension Costs
|
Sep-94
|
$793,508
|
13
|
|
CMS
|
07-94-00777
|
BC/BS of GA -
Pension Costs
|
Oct-94
|
$90,736
|
13
|
|
CMS
|
07-94-00778
|
BC/BS of GA -
Unfunded Pension Costs
|
Oct-94
|
$363,921
|
13
|
|
CMS
|
07-94-00779
|
BC/BS of GA -
Pension Seg.
|
Oct-94
|
$113,256
|
13
|
|
CMS
|
07-94-00805
|
BC/BS of TN -Pension
Seg.
|
Jan-95
|
$1,400,063
|
13
|
|
CMS
|
07-94-00816
|
BC/BS of TN.
-Unfunded Pension Costs
|
Jan-95
|
$352,026
|
13
|
|
CMS
|
07-94-00817
|
BC/BS of AL -
Pension Unfunded Costs
|
Jul-95
|
$912,730
|
13
|
|
CMS
|
07-94-00818
|
BC/BS of AL -
Pension Seg.
|
Jul-95
|
$951,281
|
13
|
|
CMS
|
07-94-01107
|
BC/BS of FL -
Pension Seg.
|
Apr-96
|
$813,122
|
13
|
|
CMS
|
07-95-01126
|
BC/BS of FL -
Pension Unfunded Costs
|
Apr-96
|
$4,049,889
|
13
|
|
CMS
|
07-95-01149
|
BC/BS of TX -
Pension Costs
|
Apr-96
|
$874,111
|
13
|
|
CMS
|
07-95-01150
|
BC/BS of Oregon -
Pension Seg.
|
Aug-97
|
$191,312
|
5
|
|
CMS
|
07-95-01159
|
BC/BS of NE -
Pension Seg.
|
Jan-96
|
$96,955
|
27
|
|
CMS
|
07-95-01166
|
BC/BS of NE -
Pension Unfunded Costs
|
Jan-96
|
$73,509
|
27
|
|
CMS
|
07-96-01189
|
BC of WA & AK-
Pension Seg.
|
Dec-97
|
$96,740
|
5
|
|
CMS
|
07-96-01194
|
Community Mutual
Ins. Co. Pension Seg.
|
Jul-97
|
$1,866,026
|
5
|
|
CMS
|
07-97-01205
|
BC of WA & AK
- Pension Seg.
|
Dec-97
|
$15,688
|
5
|
|
CMS
|
07-97-01206
|
BC of WA & AK
- Pension Unfunded Costs
|
Dec-97
|
$106,843
|
5
|
|
CMS
|
07-97-01207
|
Community Mutual Ins. Co. Unfunded
Pen
|
Sep-00
|
$571,413
|
5
|
|
CMS
|
07-97-01208
|
Community Mutual Ins Co Pension
Costs
|
Sep-00
|
$991,972
|
5
|
|
CMS
|
07-97-01209
|
BC/BS of MS -
Pension Seg.
|
Jan-98
|
$224,711
|
13
|
|
CMS
|
07-97-01210
|
BC/BS of MS -
Unfunded Pension Costs
|
Jan-98
|
$482,549
|
13
|
|
CMS
|
07-97-01211
|
BC/BS of MS -
Pension Costs
|
Jan-98
|
$134,312
|
13
|
|
CMS
|
07-97-01213
|
Travelers Pension
Seg.
|
Jan-98
|
$5,624,747
|
5
|
|
CMS
|
07-97-01222
|
AdminaStar Federal
of KY - Pension Seg.
|
Oct-98
|
$1,236,890
|
13
|
|
CMS
|
07-97-02500
|
Anthem BC/BS of
CT
|
Mar-98
|
$122,548
|
5
|
|
CMS
|
07-98-01224
|
AdminaStar Federal -
Unfunded Pension
|
Oct-98
|
$4,286,294
|
5
|
|
CMS
|
07-98-01225
|
AdminaStar Federal -
Pension Costs
|
Oct-98
|
$736,134
|
5
|
|
CMS
|
07-98-02501
|
Anthem BC/BS of CT -
Unfunded Pension
|
Mar-98
|
$292,152
|
5
|
|
CMS
|
07-98-02522
|
BS of CA - Pension
Plan Terminated
|
Apr-99
|
$7,623,524
|
5
|
|
CMS
|
07-99-01278
|
Rebound Inc.
|
Apr-02
|
$1,042,522
|
5
|
|
CMS
|
07-99-01288
|
Wellmark, Inc.
|
Nov-01
|
$1,169
|
5
|
|
CMS
|
07-99-02540
|
General American
Life Insurance Company
|
Jul-00
|
$6,205,564
|
27
|
|
CMS
|
08-00-64575
|
State of CO
|
May-00
|
$11,205,906
|
13
|
|
CMS
|
08-94-00739
|
BC/BS of ND -
Pension Seg.
|
Jan-95
|
$730,875
|
13
|
|
CMS
|
08-94-00740
|
BC/BS of NC -
Unfunded Pension Costs
|
Jan-95
|
$671,198
|
13
|
|
CMS
|
09-89-00162
|
Nationwide Employer
Project - MSP
|
Mar-95
|
$2,218,824
|
16
|
|
CMS
|
09-95-00072
|
CA DHS
|
Nov-96
|
$4,013,490
|
5
|
|
CMS
|
09-96-00061
|
BS of CA
|
Jun-98
|
$1,006,192
|
18
|
|
CMS
|
09-96-00064
|
San Diego Hospice
Corp. - ORT
|
Nov-98
|
$993,779
|
5
|
|
CMS
|
09-96-00088
|
Care Providers- BC
of CA
|
Jul-99
|
$901,278
|
5
|
|
CMS
|
09-96-00089
|
Care Plus Home Hlth
Services - BC of CA
|
Jul-99
|
$389,497
|
5
|
|
CMS
|
09-96-00094
|
BC of
Ca - Dynasty Home Hlth Inc
|
Jan-02
|
$217,720
|
5
|
|
CMS
|
14-96-00202
|
Excluded Unlicensed
Health Care Providers
|
Sep-97
|
$2,931
|
5
|
|
CMS
|
17-95-00096
|
HCFA
Financial Statement Audit for FY 1996
|
May-98
|
$300,000
|
5
|
|
CMS
|
17-97-00097
|
HCFA Financial
Statement Audit for FY 1997
|
Sep-98
|
$141,796
|
5
|
|
|
|
Total for CMS
|
|
$475,082,478
|
|
|
HRSA
|
04-98-50281
|
Aaron E. Henry
CHC
|
Sep-98
|
$3,017
|
6
|
|
HRSA
|
08-02-70421
|
Aberdeen Area Tribal
Chairmen's Hlth Board
|
Feb-03
|
$1,509
|
6
|
|
|
|
Total for HRSA
|
|
$4,526
|
|
|
IHS
|
08-00-56759
|
SD Urban Indian
Health
|
Nov-99
|
$32,783
|
5
|
|
IHS
|
08-00-59899
|
SD Urban Indian
Health
|
Nov-99
|
$6,818
|
5
|
|
IHS
|
08-00-60654
|
Spirit Lake
|
Jan-00
|
$22,031
|
5
|
|
IHS
|
08-00-61777
|
Turtle Mountain Band
of Chippewa Indians
|
Nov-99
|
$129,070
|
5
|
|
IHS
|
08-99-55284
|
SD Urban Indian
Health
|
Jun-99
|
$902,046
|
5
|
|
IHS
|
08-99-55285
|
SD Urban Indian
Health
|
Jun-99
|
$902,377
|
5
|
|
IHS
|
08-99-56446
|
Sisseton-Wahpeton
Sioux Tribe
|
May-99
|
$5,843
|
5
|
|
IHS
|
09-00-60032
|
Lovelock Paiute
Tribe
|
Dec-99
|
$74,187
|
5
|
|
IHS
|
09-01-65664
|
Lovelock Paiute
Tribe
|
Dec-00
|
$50,473
|
5
|
|
IHS
|
09-01-67778
|
Lovelock Paiute
Tribe
|
Jun-01
|
$19,129
|
5
|
|
IHS
|
09-01-68215
|
Pyramid Lake Paiute
Tribe
|
Sep-01
|
$14,919
|
5
|
|
|
|
Total for IHS
|
|
$2,159,676
|
|
|
OPHS
|
03-02-72652
|
National Assoc for
Equal Opportunity
|
Jun-02
|
$313,256
|
5
|
|
OPHS
|
03-03-74002
|
Minority Access
Inc
|
Oct-02
|
$8,113
|
5
|
|
OPHS
|
03-04-75382
|
National Hispanic
Medical Assoc.
|
Mar-03
|
$10,505
|
28
|
|
OPHS
|
03-04-76133
|
Minority Access
Inc
|
Jun-03
|
$11,141
|
28
|
|
OPHS
|
06-03-74833
|
Amigo Volunteers in
Education & Services
|
Jan-03
|
$31,180
|
28
|
|
OPHS
|
08-03-74361
|
Porcupine
Clinic
|
Nov-02
|
$12,611
|
28
|
|
OPHS
|
08-03-74833
|
Porcupine
Clinic
|
Nov-02
|
$65,027
|
28
|
|
OPHS
|
15-01-20002
|
Congress
Heights
|
May-01
|
$11,300
|
28
|
|
|
|
Total for
OPHS
|
|
$463,133
|
|
|
OS
|
01-01-00004
|
State of ME
|
Sep-01
|
$4,047
|
4
|
|
OS
|
02-99-02004
|
Puerto Rico
|
Sep-01
|
$15,601,255
|
6
|
|
OS
|
03-00-63670
|
State of PA
|
Nov-00
|
$11,388,686
|
1
|
|
OS
|
06-00-61716
|
TX Dept. of
Health
|
Sep-00
|
$138,870
|
6
|
|
OS
|
08-99-59826
|
Crow Creek Sioux
Tribe
|
Feb-00
|
$14,448
|
6
|
|
OS
|
09-97-48247
|
Karidat
|
Dec-97
|
$50,612
|
1
|
|
OS
|
09-97-48966
|
Karidat
|
Jan-98
|
$2,234
|
1
|
|
OS
|
09-98-52613
|
Marianas
|
Dec-98
|
$639,432
|
6
|
|
OS
|
09-99-57597
|
Bear River
Band
|
Mar-00
|
$1,648
|
6
|
|
OS
|
09-02-70938
|
Pascua Yaqui Tribe
of Arizona
|
Jun-02
|
$1,729
|
6
|
|
OS
|
09-02-72300
|
State of CA
|
Jul-02
|
$577,441
|
6
|
|
OS
|
10-02-71415
|
Nooksack Indian
Tribe
|
Dec-02
|
$78,313
|
5
|
|
|
|
Total for
OS
|
|
$28,498,715
|
|
|
PSC/DCA
|
03-90-00453
|
State of WV
|
Mar-91
|
$12,850,856
|
7
|
|
PSC/DCA
|
06-99-59584
|
State of LA
|
Sep-00
|
$19,261,661
|
1
|
|
|
|
Total for
PSC
|
|
$32,112,517
|
|
|
SAMHSA
|
02-99-02502
|
Southeast Queens
Community Partnership, Inc.
|
May-00
|
$500,263
|
2
|
|
SAMHSA
|
04-04183
|
Columbus Co.
Services Mgmt.
|
Jul-94
|
$35,167
|
4
|
|
|
|
Total for
SAMHSA
|
|
$535,430
|
|
|
|
|
|
|
|
|
|
|
|
Total for
HHS
|
|
$571,262,325
|
|
|
Notes:
|
|
1.
Appeal process.
|
|
2.
Referred to Department of Justice (DOJ).
|
|
3.
Referred to DOJ/payment plan.
|
|
4.
Payment plan.
|
|
5.
Pursuing collection.
|
|
6.
Transferred to Treasury Offset Program.
|
|
7.
In District Court.
|
|
8.
Contractor has signed the closing agreement. An
amended OCD is being prepared.
|
|
9.
Contractor appealed and court ruled in contractor's
favor. HHS agency has appealed.
|
|
10. Pending
resolution of contractor's termination audit, any
related termination agreement and pending lawsuit.
|
|
11. HHS agency
has instructed the carrier to calculate and recover
partial overpayments. Recoupment is still on hold
pending resolution of the company's
|
|
appeal to an administrative law judge.
|
|
12. Additional
documentation has been provided by the State or
contractor. OIG and/or HHS Agency reviewing.
|
|
13. HHS agency
is working with all Medicare providers to obtain signed
advance agreements which set forth the terms
|
|
and
conditions of the amended Cost Accounting Standards (CAS
412). Implementation of the advance agreements will
subsume and close out the currently
|
|
outstanding pension audits.
|
|
14. HHS agency
is in process of negotiating or determining outstanding
overpayment amount and/or payment options.
|
|
15. HHS agency
will verify that corrective action has been completed by
the fiscal intermediary.
|
|
16. Demand
letters were sent to employers listed in the audit.
D.C. Circuit Court's decision in HIAA vs. Shalala case
will result in few recoveries
|
|
of
funds from EGHP's timely filing limits. HHS
agency is attempting to "fix” the HIAA
decision via new legislation.
|
|
17. Contractor
was declared insolvent and placed in receivership.
DOJ has filed a claim on HHS agency's
behalf.
|
|
18. HHS Agency
is negotiating a settlement with the State or the
contractor.
|
|
19. HHS Agency
is of developing a formula to settle all waivers regarding
pension segmentation and/or unfunded pension
costs.
|
|
20. HHS Agency
is awaiting verification from the pension actuarial staff
that an adjustment was made.
|
|
21. An on-site
audit is in process. A global settlement will close
pension and administrative costs.
|
|
22. The State
or contractor is in the process of determining or
collecting overpayment.
|
|
23. Collection
activity has been suspended pending resolution of an
objection lodged by two providers' legal counsel with
the OIG and the Office of General Counsel.
|
|
24. HHS agency
is verifying collection of overpayment.
|
|
25. Awaiting
confirmation that account receivable may be closed
out.
|
|
26. Waiting
for a decision and/or action by the Asst. U.S.
Attorney.
|
|
27. HHS agency
is negotiating with the contractor on the related
administrative costs audit.
|
|
28. HHS agency
to examine related claims.
|
|
29. Working
with new Executive Director to resolve all issues.
|
|
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