Physician Indicted in $6 Million Medicare Fraud Scheme

A California woman was arrested Thursday in Los Angeles on criminal health care fraud charges arising from her false home health certifications and related fraudulent billings to Medicare.

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    Federal agencies, including the Department of Energy (DOE) and the separately organized National Nuclear Security Administration (NNSA) within DOE, and uranium industry representatives have identified risks to the commercial supply chain for uranium needed for defense purposes. Such uranium may need to be mined domestically and enriched using U.S. technology to be free of obligations for the peaceful use of uranium and certain technology imported under international agreements. Identified risks to the unobligated uranium supply chain include (1) possible loss of domestic uranium mining capabilities and (2) possible challenges in re-starting the only facility in the United States for converting natural uranium into a form suitable for use in enrichment operations. Further, the U.S. has not had an operating enrichment capability that uses U.S. technology since 2013. Idle Domestic Plant for Converting Uranium to a Form Suitable for Enrichment DOE and NNSA have initiated actions officials believe will mitigate such risks to the unobligated uranium supply chain. For example, DOE and NNSA have both taken steps to reestablish a domestic enrichment capability with U.S. technology. In addition, DOE has proposed creation of a domestic uranium reserve to help support the domestic uranium mining and conversion industries until market conditions improve. DOE's fiscal year 2021 budget request includes $150 million for the reserve. However, we cannot conclude that the estimate is reasonable because it is unclear how the funding needs for the reserve were determined. By providing a more complete analysis to support future funding requests for the reserve, DOE could better provide assurance that such requests would achieve objectives. The Nuclear Fuel Working Group's strategy to mitigate risks to the domestic uranium industry does not fully incorporate all desirable characteristics GAO has identified for a national strategy. For example, it does not identify (1) the level of resources needed to support proposed actions or (2) an interagency coordinating mechanism. DOE is developing an implementation plan for the strategy, but DOE officials provided conflicting statements about the extent to which the agency will coordinate interagency implementation. NNSA has several defense needs for enriched uranium, including low-enriched uranium to produce tritium for nuclear weapons. To meet these needs, NNSA relies on commercial sectors of the domestic uranium industry, such as uranium mining or enrichment, which make up a supply chain for unobligated uranium. However, this industry faces commercial viability risks. In April 2020, the President's Nuclear Fuel Working Group released a strategy to mitigate risks to the domestic uranium industry. This working group includes DOE, the Department of Defense, and other agencies. Senate Report 115-262 included a provision that GAO review NNSA's planning for the future supply of unobligated enriched uranium. This report examines (1) risks agencies and others have identified to the unobligated uranium supply chain and agency actions to mitigate those risks, and (2) the extent to which the Nuclear Fuel Working Group's risk mitigation strategy incorporates desirable characteristics of a national strategy. GAO analyzed key NNSA and DOE planning documents and interviewed NNSA and other agency officials and industry representatives. GAO is making three recommendations, including that DOE improve its cost estimate to support future funding requests for the proposed uranium reserve and ensure its implementation plan for the strategy addresses each of the desirable characteristics of a national strategy. DOE concurred with GAO's recommendations. For more information, contact at (202) 512-3821 or bawdena@gao.gov.
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  • NASA Human Space Exploration: Significant Investments in Future Capabilities Require Strengthened Management Oversight
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    The National Aeronautics and Space Administration (NASA) again delayed the planned launch date for Artemis I, the first uncrewed test flight involving three closely related human spaceflight programs—the Orion crew vehicle, Space Launch System (SLS), and Exploration Ground Systems (EGS). Together, these programs aim to continue human space exploration beyond low-Earth orbit. The most recent delay, to November 2021, resulted in part from manufacturing challenges and represents a 36-month slip since NASA established a schedule to measure performance in 2014. This new launch date does not account for the effects of COVID-19. According to NASA officials, COVID-19 delays and schedule risks will place pressure on NASA's ability to achieve this launch date. Development cost estimates for key programs also increased. The cost of the SLS program increased by 42.5 percent and the EGS program by 32.3 percent since 2014, for a combined increase of over $3 billion, bringing the total to $11.5 billion. NASA does not plan to complete revised estimates for Orion, which are tied to the second, crewed test flight (Artemis II) before spring 2021. Key Parts of Space Launch System Ready for Testing at Stennis Space Center NASA awarded billions of dollars in development and production contracts to support flights beyond Artemis I, but the flight schedule has changed frequently due to a lack of clear requirements and time frames for planned capability upgrades. Limited NASA oversight also places efforts to plan and execute future flights at risk of adverse outcomes, such as increased costs or delays. For example, NASA is committed to establishing cost and schedule performance baselines for these efforts, but it plans to do so too late in the acquisition process to be useful as an oversight tool. In addition, senior leaders do not receive consistent and comprehensive information at quarterly briefings on future efforts, such as a program to begin developing a more powerful upper stage for SLS. This is because current updates provided to NASA management focus primarily on the more short-term Artemis I and II flights. This approach places billions of dollars at risk of insufficient NASA oversight. NASA is pursuing an aggressive goal to return American astronauts to the surface of the Moon by the end of 2024. The success of NASA's plans hinges, in part, on two upcoming test flights. An uncrewed test flight and subsequent crewed test flight are intended to demonstrate the capability of a new launch vehicle, crew capsule, and ground systems. The House Committee on Appropriations included a provision in its 2017 report for GAO to continue to review NASA's human space exploration programs. This is the latest in a series of GAO reports addressing this topic. This report assesses (1) the progress the programs are making towards the first test flight, known as Artemis I, with respect to schedule and cost, and (2) the extent to which NASA's human space exploration programs are positioned to support the planned Artemis flight schedule beyond Artemis I. To do this work, GAO examined program cost and schedule reports, test plans, and contracts, and interviewed officials. GAO also assessed the extent to which the COVID-19 state of emergency has affected schedules for these programs. GAO is making two recommendations to NASA to establish baselines ahead of a key design review and improve internal reporting about capability upgrades for human space exploration programs beyond Artemis I. NASA concurred with the recommendations made in this report. For more information, contact William Russell at (202) 512-4841 or russellw@gao.gov.
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  • Justice Department Settles with School Board to Resolve Immigration-Related Discrimination Claims
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  • Veteran Suicide: VA Needs Accurate Data and Comprehensive Analyses to Better Understand On-Campus Suicides
    In U.S GAO News
    The Department of Veterans Affairs' (VA) process for identifying on-campus suicides does not include a step for ensuring the accuracy of the number of suicides identified. As a result, its numbers are inaccurate. VA's Veterans Health Administration (VHA) first started tracking on-campus veteran suicides in October 2017, and uses the results to inform VA leadership and Congress. GAO reviewed the data and found errors in the 55 on-campus veteran suicides VHA identified for fiscal years 2018 and 2019, including 10 overcounts (deaths that should not have been reported but were) and four undercounts (deaths that should have been reported but were not).   Examples of Errors on the Department of Veterans Affairs' (VA) List of 55 On-Campus Veteran Suicides for Fiscal Years 2018 and 2019 (as of September 2019) VA has taken some steps to address on-campus veteran suicides, such as issuing guidance and staff training. However, GAO found that the analyses informing these efforts are limited. Specifically, VHA requires root cause analyses—processes to determine what can be done to prevent recurrences of incidents—for some but not all on-campus veteran suicides. According to VHA officials, only 25 percent of on-campus suicides from October 2017 to April 2019 met the criteria for a root cause analysis. does not make use of all relevant information VA collects about these deaths, such as clinical and demographic data collected through other VA suicide prevention efforts. VHA officials said they could not link the different sources of information, but GAO found that selected medical facilities could do so. Without accurate information on the number of suicides and comprehensive analyses of the underlying causes, VA does not have a full understanding of the prevalence and nature of on-campus suicides, hindering its ability to address them. VA established suicide prevention as its highest clinical priority. In recent years, there have been reports of veterans dying by suicide on VA campuses—in locations such as inpatient settings, parking lots, and on the grounds of cemeteries. GAO was asked to review veteran deaths by suicide on VA campuses. This report examines (1) VA's process to track the number of veterans that died by suicide on VA campuses, and (2) steps VA has taken to address these types of suicides. GAO reviewed the sources of information VHA uses to identify and analyze on-campus veteran suicides, VA and VHA strategic plans and policies related to suicide prevention and reporting, and federal internal control standards. GAO also interviewed VA and VHA central office officials, and officials from three medical facilities that GAO selected because they reportedly had on-campus veteran suicides between fiscal years 2018 and 2019. GAO is making three recommendations, including that VA improve its process to accurately identify all on-campus veteran suicides and conduct more comprehensive analyses of these occurrences. VA did not concur with one of GAO's recommendations related to conducting root cause analyses. GAO continues to believe that this recommendation is valid, as discussed in the report. For more information, contact Debra A. Draper at (202) 512-7114 or draperd@gao.gov.
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  • Department of Justice Releases Report on its Efforts to Disrupt, Dismantle, and Destroy MS-13
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  • Defense Management: Opportunities Exist to Improve DOD’s Reform Efforts
    In U.S GAO News
    What GAO Found The Department of Defense (DOD) has long sought to reform its enterprise business operations—such as its processes to manage contracts, finances, and supply chain— but faces challenges in improving department-wide management. DOD has taken some actions to improve its business operations data, but remains limited by the lack of reliable cost data, affecting its ability to monitor and inform its reform efforts. Having reliable data to identify baseline costs of the department's business and management functions and to measure progress has been a key challenge facing DOD, but one the department is trying to address. As GAO reported in November 2020, DOD has made progress in setting baseline costs of certain activities, such as logistics and real estate management. Further, DOD has ongoing efforts to develop baselines for all of the department's enterprise business operations that should enable it to better monitor reform progress. However, DOD needs better data about how it performs its business functions. For example, in September 2018, GAO reported that DOD's efforts to reduce inefficiencies in human resources services were hampered by inconsistent performance data across the six organizations that provide these services. DOD has ongoing efforts to address GAO's recommendations. DOD still needs clear roles, responsibilities, authorities and dedicated resources to support reform. GAO has found that demonstrating sustained leadership commitment—including through ensuring that those responsible for leading change have clearly defined and documented roles, responsibilities, and authorities—is imperative for successful business transformation. GAO has assessed many of DOD's organizational structures over the decades, including the recently eliminated Chief Management Officer (CMO) position. GAO found that, while Congress had given the CMO both significant responsibilities and authorities, DOD had not resolved unanswered questions about how those authorities would be carried out, nor communicated the CMO's roles and responsibilities department-wide. GAO also identified instances where CMO reforms were hampered by a lack of resources. As DOD moves to an organization without the CMO position, which was eliminated in 2021, clarifying the roles and responsibilities of those tasked with managing business reform remains important. DOD could also improve its efforts to reliably demonstrate progress toward meaningful reform. DOD has reported achievements from some of its department-wide efforts, such as its reported $37 billion in savings from fiscal years 2017 to 2021. However, GAO reported in November 2020 that while DOD's reported savings were largely reflected in its budget materials, the underlying analyses were not always well documented and the savings were not always consistent with the department's definitions of reform. For example, one reform initiative was based on delaying military construction projects that, according to DOD officials, allowed DOD to fund higher priorities. If a delayed project is still planned, however, the costs will likely be realized in a future year and are not a reflection of business process reform. DOD concurred with GAO's recommendations to establish a process to standardize development and documentation of such cost savings, and ensure that reported savings are consistent with the department's definitions of reform. Why GAO Did This Study DOD spends billions of dollars each year to maintain key business operations and defense-wide agencies and programs intended to support the warfighter, including systems and processes related to the management of contracts, finances, the supply chain, support infrastructure, and weapon systems acquisition. The department's approach to transforming these business operations is linked to its ability to perform its overall mission, directly affecting the readiness and capabilities of U.S. military forces. This testimony summarizes GAO's past work related to DOD's efforts to improve the management of its business operations. Specifically, this testimony discusses DOD's efforts to (1) improve data and baselines to monitor and inform reform efforts; (2) establish clear roles, responsibilities, and authorities for leading reform efforts, and dedicate resources to these efforts; and (3) reliably demonstrate progress in its reform efforts. This statement is based on GAO's body of work issued from 2017 through 2020 on DOD management and business reform issues.
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