WASHINGTON – Sen. Chuck Grassley is pressing the Department of Health and Human Services to implement several recommendations to save billions of dollars and improve the quality of Medicare, Medicaid and other agency-run programs. Grassley also noted that the agency implemented greater safety checks of Head Start facilities after he cited the shortcomings in a letter last year. Grassley wrote to the agency this week about a list of top unimplemented recommendations from the Office of Inspector General’s Compendium of Unimplemented Recommendations for 2016.
“I appreciate HHS’ implementation of the OIG’s recommendations to deal with the shortcomings I raised last year,” Grassley wrote to Secretary Sylvia Mathews Burwell. “Effective oversight of Head Start grantees is necessary to ensure that tax money is spent as intended to provide a safe environment for children.”
In March 2015, Grassley wrote to HHS about unimplemented recommendations including Head Start grantees that did not fully comply with federal or state requirements to protect children from unsafe materials and equipment or conduct criminal background checks. In response, HHS noted that the Office of Head Start had revised its monitoring system such that every facility of each grantee “receives a monitoring visit and is reviewed against an Environmental Health & Safety (EnvHS) protocol.” Further, HHS stated that this monitoring would be used to assess grantee compliance with federal, state and local criminal background check requirements for all staff; health and safety requirements; meeting life safety codes; and to determine if any violations related to child maltreatment have occurred at any of the grantees’ sites.
The Administration for Children and Families has also determined that it could address federal health and safety requirements better. As such, a notice of proposed rulemaking was released on June 19, 2015, designed to strengthen health and safety requirements, to include background checks for staff. “Importantly, the rule would require Head Start programs to follow state licensing disqualification factors in making employment decisions,” Grassley wrote.
In his latest letter, Grassley asked for “a list of all Head Start grantees that did not fully comply with federal and state requirements to protect children from unsafe material and equipment and conduct proper criminal records checks as described in the OIG’s 2015 Compendium.”
Grassley also sought updates on unimplemented recommendations in several categories: ensuring that incarcerated individuals do not improperly receive Medicare payments; whether the Audit Tracking and Reporting System is not adequately collecting overpayments and audit disallowance determinations; how to fix billions of dollars in Medicare expenses over beneficiaries in skilled nursing facilities who experience “clearly or likely preventable” adverse events; inconsistencies in Medicaid upper payment limits that allow states to artificially increase the federal share of Medicaid costs; and improper payments to Medicare Advantage organizations for illegal aliens.
“In light of the findings contained within the OIG’s compendium, please detail the steps HHS plans to take, or has taken, in order to improve the implementation of the aforementioned recommendations and a projected timeline for implementation” Grassley wrote. “If HHS does not plan on implementing the recommendations, please explain why that decision was made.”
Grassley’s letter is available here.
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