[Federal Register Volume 61, Number 93 (Monday, May 13, 1996)]
[Notices]
[Pages 22059-22064]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-11844]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of the Secretary
Office of Inspector General; Statement of Organization, Functions
and Delegations of Authority
This Notice amends Part A (Office of the Secretary) of the
Statement of Organization, Functions and Delegations of Authority for
the Department of Health and Human Services (HHS) to reflect recent
changes in Chapter AF, Office of Inspector General (OIG). Chapter AF
was last published in its entirety on November 7, 1989 (54 FR 46775).
The statement of organization, functions and delegations of
authority reflects the original transfer of the statutory basis for the
Office of Inspector General from Public Law 94-505 to Public Law 95-452
(and made under the Inspector General Act Amendments of 1988, Public
Law 100-504), and conforms to and carries out the statutory
requirements for operating the Office of Inspector General. A number of
revisions have been made to the basic organizational structure of the
Office of Inspector General to reflect the break out of functions from
the Office of Civil Fraud and Administrative Adjudication (OCFAA) into
two separate organizational units, and the effect of recent shifts and
changes, such as the separation out of the Social Security
Administration in accordance with the Social Security Independence and
Program Improvements Act of 1994 (Public Law 103-296). As a result,
within the organizational structure of the OIG: (1) A new Office of
Enforcement and Compliance (OEC) and a new Office of Litigation
Coordination (OLC) have been formed, (2) certain units and positions
have recently been renamed, (3) minor shifts in reporting relationships
have occurred, (4) an additional program unit has been delineated, and
(5) some small functional units have been transferred. While relatively
minor, these changes have been made in an effort to assist the
organization in accomplishing its mission with greater efficiency and
effectiveness.
As amended, Chapter AF now reads as follows:
Section AF.00, Office of Inspector General (OIG)--Mission
This organization was established by law as an independent and
objective oversight unit of the Department to carry out the mission of
promoting economy, efficiency and effectiveness
[[Page 22060]]
through the elimination of waste, abuse and fraud. In furtherance of
this mission, the organization engages in a number of activities:
A. Conducting and supervising audits, investigations, inspections
and evaluations relating to HHS programs and operations.
B. Identifying systemic weaknesses giving rise to opportunities for
fraud and abuse in HHS programs and operations and making
recommendations to prevent their recurrence.
C. Leading and coordinating activities to prevent and detect fraud
and abuse in HHS programs and operations.
D. Detecting wrongdoers and abusers of HHS programs and
beneficiaries so appropriate remedies may be brought to bear.
E. Keeping the Secretary and the Congress fully and currently
informed about problems and deficiencies in the administration of such
programs and operations and about the need for and progress of
corrective action, including imposing sanctions against providers of
health care under Medicare and Medicaid who commit certain prohibited
acts.
In support of its mission, the Office of Inspector General carries
out and maintains an internal quality assurance system and a peer
review system with other Offices of Inspectors General, that include
periodic quality assessment studies and quality control reviews, to
provide reasonable assurance that applicable laws, regulations,
policies, procedures, standards and other requirements are followed;
are effective; and are functioning as intended in OIG operations.
Section AF.10, Office of Inspector General--Organization
There is at the head of the OIG a statutory Inspector General,
appointed by the President and confirmed by the Senate. The Office of
Inspector General consists of seven organizational units:
A. Immediate Office of the Inspector General (AFA).
B. Office of Management and Policy (AFC).
C. Office of Evaluation and Inspections (AFE).
D. Office of Enforcement and Compliance (AFF).
E. Office of Litigation Compliance (AFG).
F. Office of Audit Services (AFH).
G. Office of Investigations (AFJ).
Section AF.20, Office of Inspector General--Functions
The component sections which follow describe the specific functions
of the organization.
Section AFA.00, Immediate Office of the Inspector General (IOIG)--
Mission
The Inspector General is directly responsible for meeting the
statutory mission of the OIG as a whole and for promoting effective OIG
internal quality assurance systems, including quality assessment
studies and quality control reviews of OIG processes and products. The
Office of Inspector General also plans, conducts and participates in a
variety of inter-agency cooperative projects and undertakings relating
to fraud and abuse activities with the Department of Justice (DoJ), the
Health Care Financing Adminstration (HCFA) and other governmental
agencies.
Section AFA.10, Immediate Office of the Inspector General--
Organization
The Immediate Office comprises the Inspector General, the Principal
Deputy Inspector General, and an immediate staff.
Section AFA.20, Immediate Office of the Inspector General--
Functions
As the senior official of the organization, the Inspector General
supervises the Deputy Inspectors General and the Assistant Inspector
General for Litigation Coordination who head the major OIG components.
The Inspector General is appointed by the President, with the advice
and consent of the Senate, and reports to and is under the general
supervision of the Secretary or, to the extent such authority is
delegated, the Deputy Secretary, but does not report to and is not
subject to supervision by any other officer in the Department. In
keeping with the independence intended in the statutory basis for the
OIG and its mission, the Inspector General assumes and exercises,
through line management, all functional authorities related to the
administration and management of the OIG and all mission related
authorities stated or implied in the law or delegated directly from the
Secretary.
The Inspector General provides executive leadership to the
organization and exercises general supervision over the personnel and
functions of its major components. The Inspector General determines the
budget needs of the OIG, sets OIG policies and priorities, oversees OIG
operations and provides reports to the Secretary and the Congress. In
this capacity the Inspector General is empowered under the law with
general personnel authority, e.g., selection, promotion, assignment of
employees, including members of the senior executive service. The
Inspector General delegates related authorities as appropriate.
The Principal Deputy Inspector General assists the Inspector
General in the management of the OIG, and during the absence of the
Inspector General, acts as the Inspector General.
Section AFC.00, Office of Management and Policy (OMP)--Mission
This office is responsible for the reporting and legislative and
regulatory review functions required in the law; for formulating and
executing the OIG budget; for managing external affairs; and for
establishing functional policies for the general management of the OIG.
In support of its mission, the office carries out and maintains an
internal quality assurance system. The system includes quality
assessment studies and quality control reviews of OMP processes and
products to ensure that policies and procedures are followed
effectively and function as intended.
Section AFC.10, Office of Management and Policy--Organization
This office is directed by the Deputy Inspector General for
Management and Policy, and comprises the Deputy Inspector General for
OMP and an immediate staff.
Section AFC.20, Office of Management and Policy--Functions
Through the Deputy Inspector General for Management and Policy:
A. The office conducts and coordinates OIG reviews of existing and
proposed legislation and regulations related to HHS programs and
operations to identify their impact on economy and efficiency and their
potential for fraud and abuse. It develops all OIG sanction and
interpretive regulations for publication in the Federal Register and
legislative proposals for inclusion in the Department's legislative
program. It serves as contact for the press and electronic media and
serves as OIG congressional liaison. The office prepares congressional
testimony and confers with officials in the Office of the Secretary
staff divisions on congressional relations, legislation and public
affairs. It develops and publishes OIG newsletters, recruitment
brochures and other issuances to announce and promote OIG activities
and accomplishments.
B. The office coordinates the development of the OIG long-range
strategic plan. It compiles the Semiannual Report to the Congress and
operates the Executive Secretariat. It formulates and oversees the
execution of the OIG budget and confers with the Office of the
Secretary, the Office of
[[Page 22061]]
Management and Budget and the Congress on budget issues. It issues
quarterly grants to States for Medicaid fraud control units. It
conducts management studies and analyses and establishes and
coordinates general management policies for the OIG and publishes those
policies in the OIG Administrative Manual. It serves as OIG liaison to
the Office of the Secretary for personnel issues and other
administrative policies and practices, and on equal employment
opportunity and other civil rights matters. It coordinates internal
control reviews for the OIG.
C. The office is responsible for OIG information resources
management (IRM), as defined by the Paperwork Reduction Act, OMB
Circular A-130, the Federal Information Resources Management
regulations, the Computer Security Act of 1987, HHS IRM Circulars, and
by related guidance. The office also provides information technology
support to the OIG through management of its local area networks
nationwide, provision of headquarters computer end-user support, and
support of OIG information systems as required.
Section AFE.00, Office of Evaluation and Inspections (OEI)--Mission
The Office of Evaluation and Inspections is responsible for
conducting inspections of HHS programs, operations and processes to
identify vulnerabilities, to prevent and detect misconduct, and to
promote economy, efficiency and effectiveness in HHS programs and
operations. In support of its mission, the office carries out and
maintains an internal quality assurance system. The system includes
quality assessment studies and quality control reviews of OEI processes
and products to ensure that policies and procedures are effective; are
followed; and are functioning as intended.
Section AFE.10, Office of Evaluation and Inspections--Organization
This office is directed by the Deputy Inspector General for
Evaluation and Inspections, and comprises the Immediate Office,
including the Deputy Inspector General for OEI and an immediate staff,
and eight regional offices.
Section AFE.20, Office of Evaluation and Inspections--Functions
The office is responsible for carrying out inspections supporting
the OIG mission. The Deputy Inspector General provides general
supervision to the OEI immediate office staff and supervises the
Regional Inspectors General for Evaluation and Inspections who carry
out OEI's mission and activities in assigned geographic areas. The
Immediate Office carries out OEI's mission in headquarters.
A. The immediate office develops OEI's evaluation and inspections
policies, procedures and standards. It assesses the quality of
inspections to ensure compliance with policies and procedures. It
manages OEI's human and financial resources. It develops and monitors
OEI's management information systems. It conducts management reviews
within the HHS/OIG and for other OIG's upon request.
B. The immediate office manages OEI's work planning process and
reviews legislative, regulatory and program proposals for
vulnerabilities to fraud, waste and mismanagement. It develops
evaluation techniques and coordinates projects with other OIG and
departmental components. It provides programmatic expertise and
information on new programs, procedures, regulations and statutes to
OEI regional offices. It maintains liaison with other components in the
Department, follows up on implementation of corrective action
recommendations, evaluates the actions taken to resolve problems and
vulnerabilities identified, and provides additional data or corrective
action options, where appropriate.
C. The regional offices carry out OEI's mission in the field. The
regional offices evaluate HHS programs and produce the results in
inspection reports. They conduct data and trend analyses of major HHS
initiatives to determine the effects of current policies and practices
on program efficiency and effectiveness. They recommend changes in
program policies, regulations and laws to improve efficiency and
effectiveness, and to prevent fraud, abuse, waste and mismanagement.
They analyze existing policies to evaluate options for future policy,
regulatory and legislative improvements.
Section AFF.00, Office of Enforcement and Compliance (OEC)--Mission
The Office of Enforcement and Compliance is responsible for the
imposition of those mandatory and permissive program exclusions and
civil money penalty (CMP) and assessment actions not handled by the
Office of Litigation Coordination. The office serves as a liaison with
HCFA, State licensing boards and other outside organizations and
entities with regard to integrity, compliance and enforcement
activities. It develops models for corporate integrity, compliance and
enforcement programs; monitors ongoing compliance, exclusion and HCFA
suspension agreements; and promotes industry awareness of corporate
integrity and enforcement agreements developed by the OIG.
Section AFF.10, Office of Enforcement and Compliance--Organization
This office is directed by the Deputy Inspector General for
Enforcement and Compliance, and comprises the Deputy Inspector General
for OEC and an immediate staff.
Section AFF.20, Office of Enforcement and Compliance--Functions
Through the Deputy Inspector General for Enforcement and
Compliance:
A. The office develops, coordinates and effectuates all health care
mandatory and permissive exclusions, with the exception of those
handled by the Office of Litigation Coordination. The office develops
standards governing the imposition of the mandatory and permissive
exclusion authorities within the scope of its responsibility, and
develops criteria for evaluating when it will impose such permissive
exclusions against health care providers. It reviews all applications
for readmission to program participation for purposes of determining
whether an excluded provider has demonstrated the ability to comply
with program requirements; and ensures enforcement of exclusions
imposed through liaison with HCFA, DoJ and other governmental and
private sector entities.
B. The office is responsible for developing, improving and
maintaining a comprehensive and coordinated OIG data base on all OIG
exclusion actions, and promptly and accurately reports all exclusion
actions within its authority to the data base. It informs appropriate
regulatory agencies, health care providers and the general public of
all OIG exclusion actions, and is responsible for improving public
access to information on these exclusion actions to ensure that
excluded individuals and entities are effectively barred from program
participation.
C. The office imposes CMPs and assessments in accordance with the
CMP law on those cases not handled by the Office of Litigation
Coordination, and ensures that all monetary recoveries are promptly and
accurately reported to the appropriate OIG data base.
D. The office monitors corporate and provider compliance plans
adopted as part of settlement agreements, and develops audit and
investigative review standards for monitoring such plans in cooperation
and coordination with other OIG components. It resolves breaches of
compliance plans through the development of corrective action plans,
on-site reviews, and when appropriate,
[[Page 22062]]
refers material breaches of compliance plans to the Office of
Litigation Coordination for potential sanctioning.
E. The office serves to increase industry awareness of corporate
integrity issues by proactively promoting voluntary adoption of
corporate compliance plans through speeches, articles, visits and other
liaison activities with governmental and private sector groups.
Section AFG.00, Office of Litigation Coordination (OLC)--Mission
The Office of Litigation Coordination is responsible for the
coordination and disposition of all qui tam and other False Claims Act
matters, and other criminal, civil and administrative matters when DoJ
has an interest in the matter; the coordination and disposition of all
voluntary disclosure activities; liaison activities with HCFA and
outside entities in global settlement negotiations; the development of
standards governing use of permissive exclusion authority in cases
involving DoJ, including and United States Attorney's Office; and the
establishment and maintenance of a data system on settled and pending
False Claim Act and CMP cases.
Section AFG.10, Office of Litigation Coordination--Organization
The office is directed by the Assistant Inspector General for
Litigation Coordination, and comprises the Assistant Inspector General
of OLC and an immediate staff.
Section AFG.20, Office of Litigation Coordination--Mission
Through the Assistant Inspector General for Litigation
Coordination:
A. The office oversees all False Claims Act and qui tam cases,
including the handling of (1) requests for extensions of intervention
dates, (2) resource requests from other agencies, (3) resource
coordination among the OIG components, (4) settlement negotiations and
(5) final sign-off. By coordinating DoJ resource requests,
participating in settlement negotiations and providing litigation
support, the office serves as the primary focal point for most criminal
and civil cases involving other government agencies or more than one
OIG component. It coordinates the Department's response to all
settlement proposals in cases involving DoJ, including the amount of
restitution and resolution of the selected CMP and exclusion liability,
and serves as the liaison to other components of the Department in
these cases.
B. The office coordinates and resolves all voluntary disclosures
through (1) liaison activities with DoJ and the U.S. Attorney's office,
(2) the disclosure verification efforts of the Office of Audit Services
and the Office of Investigations and (3) final disposition and sign-off
of the matter.
C. The office, in coordination with other OIG components, develops
both the standards governing the use of permissive exclusion
authorities in cases involving other Federal agencies, including DoJ,
and the criteria for evaluating whether to impose permissive exclusions
against health care providers in such cases. It is responsible for
ensuring that all exclusion actions not handled by the Office of
Enforcement and Compliance are promptly and accurately reported to the
appropriate OIG data base.
D. The office is responsible for developing, improving and
maintaining a comprehensive and coordinated data base on all settled
and pending False Claims Act and CMP cases under its authority. The
office, through this data base, records all monetary recoveries and
tracks outstanding qui tam, OIG intercomponent and multiple agency
health care fraud investigations.
Section AFH.00, Office of Audit Services (OAS)--Mission
The Office of Audit Services provides policy direction for and
conducts and oversees comprehensive audits of HHS programs, operations,
grantees and contractors, following generally accepted Government
auditing standards (GAGAS), the Single Audit Act of 1984, applicable
Office of Management and Budget (OMB) circulars and other legal,
regulatory and administrative requirements. It maintains an internal
quality assurance system, including periodic quality assessment studies
and quality control reviews, to provide reasonable assurance that
applicable laws, regulations, policies, procedures, standards and other
requirements are followed in all audit activities performed by, or on
behalf of, the Department. In furtherance of this mission, the
organization engages in a number of activities:
A. The office coordinates and confers with officials of the central
Federal management agencies (OMB, the General Accounting Office (GAO),
the Office of Personnel Management (OPM) and the Department of the
Treasury) on audit matters involving HHS programs and operations. It
provides technical assistance to Federal, State and local investigative
offices on matters concerning the operation of the Department's
programs. It participates in interagency efforts implementing OMB
Circulars A-128 and A-110, which call for use of the single audit
concept for most external audits. It performs audits of activities
administered by other Federal departments, following the system of
audit cognizance administered by OMB. It participates in the
President's Council on Integrity and Efficiency (PCIE) initiatives and
other Government-wide projects. It works with other OIG components on
special assignments and projects. It responds to congressional
oversight interests related to audit matters in the Department.
B. The Office of Audit Services helps HHS operating divisions and
the Office of the Secretary staff divisions to develop policies to
manage grants and procurements and policies to establish indirect cost
rates. It performs pre-award audits of grant or contract proposals to
determine the financial capability of the grantees or contractors and
conducts post-award audits.
C. The office reviews legislative, regulatory and policy proposals
for audit implications. It recommends improvements in the
accountability and integrity features of legislation, regulations and
policy. It prepares reports of audits and special studies for the
Secretary, heads of HHS operating divisions, Regional Directors and
others. It gathers data on unresolved audit findings for the
statutorily required Semiannual Reports to the Congress and for the
Deputy Secretary as Chairman of the Audit Resolution Council. It
conducts follow-up examinations and special analyses of actions taken
on previously reported audit findings and recommendations to ensure
completeness and propriety.
D. The office decides when audits can or may be performed by audit
organizations outside the Department, including those by other Federal
or nonfederal governmental agencies, contractors, or public accounting
firms. It assures that any audit performed by non-OIG auditors complies
with the Government auditing standards established by the Comptroller
General of the United States. It evaluates audits performed for the
Department by outside organizations. It coordinates the development of
the OIG Annual Work Plan and produces summaries of both (1) the Orange
Book--a summary of unimplemented program and management improvements
recommended--and (2) the Red Book - a summary of significant monetary
recommendations not yet implemented.
E. The office serves as the focal point for all financial audit
activity within the Department and provides the primary liaison conduit
between the OIG and
[[Page 22063]]
departmental management. The office provides overall leadership and
direction in carrying out the responsibilities mandated under the Chief
Financial Officers Act relating to financial statement audits.
Section AFH.10, Office of Audit Services--Organization
The Office of Audit Services comprises the following components:
A. Immediate Office
B. Audit Operations and Financial Statement Activities.
C. Health Care Financing Audits.
D. Administrations of Children, Family and Aging Audits.
E. Public Health Audits.
Section AFH.20, Office of Audit Services--Functions
A. Immediate Office of the Deputy Inspector General for Audit
Services. This office is directed by the Deputy Inspector General for
Audit Services who carries out the functions designated in the law for
the position, Assistant Inspector General for Auditing. The Deputy
Inspector General for Audit Services is responsible to the Inspector
General for carrying out OIG's audit mission and supervises the
Assistant Inspectors General heading OAS offices described below.
The Immediate Office manages the human and financial resources of
the Office of Audit Services including developing staffing allocation
plans and issuing policy for, coordinating and monitoring all budget,
staffing, recruiting and training activities of the office. It
maintains a professional development program for Office of Audit
Services staff which meets the requirements of Government auditing
standards. The office provides liaison with the General Accounting
Office. It reviews all replies to GAO reports to ensure they are
responsive, properly coordinated and representative of HHS policy and
advises the Secretary and other officials about significant findings.
B. Audit Operations and Financial Statement Activities. This office
is directed by the Assistant Inspector General for Audit Operations and
Financial Statement Activities. In addition to directing this office,
the Assistant Inspector General supervises the eight Regional
Inspectors General for Audit Services. The office's principal functions
include providing direction and oversight to OAS through its work
planning and quality assurance activities; the direct-line
responsibility for audits of financial statements and financial related
audits, including internal audits of functional areas within the
Department; and directing field audit operations.
1. The office serves as the focal point for all financial statement
and financial related audit activity within the Department and serves
as the primary liaison conduit between the OIG and departmental
management.
2. The office operates an internal quality assurance system that
provides reasonable assurance that applicable laws, regulations,
policies, procedures, standards and other requirements are followed in
all audit activities performed by, or on behalf of, the Department.
3. The office evaluates audit work, including performing quality
control reviews of audit reports, and develops and monitors audit work
plans. It develops audit policy, procedures, standards, criteria and
instructions for all audit activities performed by, on behalf of, or
conforming with departmental programs, grants, contracts or operations
in accordance with GAGAS and other legal, regulatory and administrative
requirements.
4. The office tracks, monitors and reports on audit resolution and
follow-up in accordance with OMB Circular A-50.
5. The office provides oversight for audits of governments,
universities and nonprofit organizations conducted by nonfederal
auditors and those under contract with the OIG (external audit
resources).
6. The office coordinates with the other OIG components in
developing the semiannual report to Congress.
C. Health Care Financing Audits. This office is directed by the
Assistant Inspector General for Health Care Financing Audits. The
office conducts audits of HCFA program operations and oversees
nationwide the audits of the Medicare and Medicaid programs, their
contractors, and providers of services and products. It maintains an
internal quality assurance system, including periodic quality control
reviews, to provide reasonable assurance that applicable laws,
regulations, policies, procedures, standards and other requirements are
followed in all HCFA audit activities performed by, or on behalf of,
the Department.
D. Administrations of Children, Family and Aging Audits. This
office is directed by the Assistant Inspector General for
Administrations of Children, Family and Aging Audits. The office
conducts and oversees audits of the operations and programs of the
Administration for Children and Families and the Administration on
Aging, as well as statewide cost allocation plans. It maintains an
internal quality assurance system, including periodic quality control
reviews, to provide reasonable assurance that applicable laws,
regulations, policies, procedures, standards and other requirements are
followed in its audit activities.
E. Public Health Audits. This office is directed by the Assistant
Inspector General for Public Health Audits. The office conducts and
oversees audits of the programs and activities of the public health
related agencies, including the Food and Drug Administration; the
National Institutes of Health; the Health Resources and Services
Administration; the Alcohol, Drug Abuse, and Mental Health
Administration; the Centers for Disease Control and Prevention; the
Agency for Toxic Substances and Disease Registry; the Indian Health
Service and the Surgeon General, as well as those colleges,
universities and nonprofit organizations that receive research grants
from the Federal Government. It maintains an internal quality assurance
system, including periodic quality control reviews, to provide
reasonable assurance that applicable laws, regulations, policies,
procedures, standards and other requirements are followed in all public
health related audit activities performed by, or on behalf of, the
Department.
Section AFJ.00, Office of Investigations (OI)--Mission
The Office of Investigations is responsible for conducting and
coordinating investigative activities related to fraud, waste, abuse
and mismanagement in HHS programs and operations, including wrongdoing
by applicants, grantees, or contractors, or by HHS employees in the
performance of their official duties. It serves as OIG liaison to DoJ
on all matters relating to investigations of HHS programs and
personnel, and reports to the Attorney General when the OIG has
reasonable grounds to believe Federal criminal law has been violated.
It works with other investigative agencies and organizations on special
projects and assignments. In support of its mission, the office carries
out and maintains an internal quality assurance system. The system
includes quality assessment studies and quality control reviews of OI
processes and products to ensure that policies and procedures are
followed effectively, and are functioning as intended.
Section AFJ.10, Office of Investigations--Organization
The Office of Investigations comprises the following components:
A. Immediate Office.
B. Criminal Investigations.
[[Page 22064]]
C. Investigations Policy and Oversight.
Section AFJ.20, Office of Investigations--Functions
A. Immediate Office of the Deputy Inspector General for
Investigations. This office is directed by the Deputy Inspector General
for Investigations who is responsible for the functions designated in
the law for the position, Assistant Inspector General for
Investigations. The Deputy Inspector General for Investigations
supervises the Assistant Inspectors General who head the OI offices
described below.
The Deputy Inspector General for Investigations is responsible to
the Inspector General for carrying out the investigative mission of the
OIG and for leading and providing general supervision to the OIG
investigative component. The Immediate Office coordinates quality
assurance studies to ensure that applicable laws, regulations,
policies, procedures, standards and other requirements are followed in
all investigative activities performed by, or on behalf of, the
Department.
B. Criminal Investigations. This office is directed by the
Assistant Inspector General for Criminal Investigations who supervises
a headquarters policy and review staff and the Regional Inspectors
General for Investigations who carry out investigative activities in
their assigned geographic areas.
1. The headquarters staff assists the Deputy Inspector General for
Investigations to establish investigative priorities, to evaluate the
progress of investigations, and to report to the Inspector General on
the effectiveness of investigative efforts. It develops and implements
investigative techniques, programs, guidelines and policies. It
provides programmatic expertise and issues information on new programs,
procedures, regulations and statutes. It directs and coordinates the
investigative field offices.
2. The headquarters staff reviews completed reports of
investigations to ensure accuracy and compliance with guidelines. It
issues the reports to pertinent agencies, management officials and the
Secretary and recommends appropriate debarment actions, administrative
sanctions, CMPs and other civil actions, or prosecution under criminal
law. It identifies systemic and programmatic vulnerabilities in the
Department's operations and makes recommendations for change to the
appropriate managers.
3. The staff provides for the personal protection of the Secretary.
4. The field offices conduct investigations of allegations of
fraud, waste, abuse, mismanagement and violations of standards of
conduct and other investigative matters within the jurisdiction of the
OIG. They coordinate investigations and confer with HHS operating
divisions, staff divisions, OIG counterparts and other investigative
and law enforcement agencies. They prepare investigative and management
improvement reports.
C. Investigations Policy and Oversight. This office is directed by
the Assistant Inspector General for Investigations Policy and Oversight
who leads outreach activities to State and local investigative
agencies, and the general management functions of the Office of
Investigations.
1. The office oversees State Medicaid fraud control units and is
responsible for certifying and recertifying these units and for
auditing their Federal funding. The office provides pertinent
information from HHS records to assist Federal, State and local
investigative agencies to detect, investigate and prosecute fraud. It
manages the HHS Hotline to receive complaints and allegations of fraud,
waste and abuse, and to refer the information for investigation, audit,
program review, or other appropriate action. It coordinates with the
GAO hotline and hotlines from other agencies.
2. The office maintains an automated data and management
information system used by all OI managers and investigators. It
provides technical expertise on computer applications for
investigations and coordinates and approves investigative computer
matches with other agencies.
3. The office develops general management policy for the OI. It
develops and issues instructional media on detecting wrongdoing and on
investigating and processing cases. The office reviews proposed
legislation, regulations, policies and procedures to identify
vulnerabilities and recommends modification where appropriate. It
reviews investigative files in response to Privacy and Freedom of
Information Act requests. It plans, develops, implements and evaluates
all levels of employee training for investigations, management, support
skills and other functions, and serves as OIG liaison to the Office of
the Secretary for Freedom of Information and Privacy Act requests. It
coordinates general management processes, e.g., compiles reports on the
budget, on awards and on other personnel matters for OI as a whole;
implements policies and procedures published in the OIG Administrative
Manual; and processes procurement requests and other service related
actions.
Dated: April 25, 1996.
June Gibbs Brown,
Inspector General.
[FR Doc. 96-11844 Filed 5-10-96; 8:45 am]
BILLING CODE 4150-04-P
