The Office of Personnel Management (OPM) Healthcare & Insurance--Federal Employee Insurance Operations office, which we refer to as OPM's contracting office, monitors Federal Employees Health Benefits Program (FEHBP) carriers' compliance with requirements and other guidance for preventing, detecting, and eliminating fraud and abuse. These requirements include establishing a program to assess vuln

The Medicaid Integrity Group's (MIG) hiring of separate review and audit contractors for its National Medicaid Audit Program (NMAP) was inefficient and led to duplication because key functions were performed by both entities. Review contractors analyze state claims data to identify aberrant claims or billing anomalies while audit contractors conduct postpayment audits to determine if payments to

As part of Medicare's Part D Coverage Gap Discount Program (Discount Program), the Centers for Medicare & Medicaid Services (CMS), located within the Department of Health and Human Services (HHS), oversees the provision of discounts by plan sponsors to eligible beneficiaries when they purchase brand-name drugs and monitors that discounts are paid for by drug manufacturers. CMS checks prescription

The number of drug shortages has grown substantially since 2006. In total, 1,190 shortages were reported from January 1, 2001, through June 20, 2011, according to UUDIS data. From 2006 through 2010, the number of drug shortages increased each year. A record number of shortages were reported in 2010, and 2011 is on pace to surpass 2010's record. Sixty-five percent of shortages involved drugs that

BJA collects an array of data on adult drug-court grantees, such as drug-court completion rates, and during the course of GAO's review, began expanding its use of this performance data to inform grant-related decisions, such as allocating resources and setting program priorities. For example, during September 2011, BJA assessed a sample of adult drug-court grantees' performance across a range of

The key challenge faced by the Medicaid Integrity Group (MIG) is the need to avoid duplication of federal and state program integrity efforts, particularly in the area of auditing provider claims. In 2011, the MIG reported that it was redesigning its national provider audit program. Previously, its audit contractors were using incomplete claims data to identify overpayments. According to MIG data

From March through September 2008, we reported on shortcomings in EPA's IRIS process that limited the agency's ability to complete timely and credible IRIS assessments. For example, the Office of Management and Budget (OMB) required and managed interagency reviews of IRIS assessments, and OMB determined when assessments could proceed to the next process step, frequently resulting in delayed IRIS

VA has made progress addressing each of the recommendations from GAO's March 2011 report on program management issues related to enrollment decisions, caseloads, and program staffing needs and placement decisions for the Federal Recovery Coordinators (FRC) the FRCP uses to coordinate care. These recommendations were directed to the Secretary of VA because VA maintains administrative control of th