[Federal Register Volume 62, Number 108 (Thursday, June 5, 1997)]
[Notices]
[Pages 30859-30865]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-14611]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

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 May 13, 1996 (61 FR 22059).
    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 reflect the consolidation of the Inspector 
General Division of the Office of the General Counsel and the Office of 
Litigation Coordination into the new Office of Counsel to the Inspector 
General (OCIG), and the incorporation of OCIG into the OIG 
organizational structure. In addition, several technical changes have 
been made to reflect revised component functions and duties in 
accordance with new or amended authorities and responsibilities 
resulting from the Health Insurance Portability and Accountability Act 
of 1996 (Public Law 104-191). These organizational changes have been 
made in an effort to assist the

[[Page 30860]]

Office of Inspector General 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 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 Counsel to the Inspector General (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 Administration (HCFA) and other governmental 
agencies.
    Section AFA.10, Immediate Office of the Inspector General--
Organization. The Immediate Office is comprised of 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 Chief Counsel to the Inspector General and the 
Deputy Inspectors General 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 serves as contact for the press and 
electronic media and serves as OIG congressional liaison. The office 
prepares or coordinates 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 and other legislatively-
mandated reports 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 Management 
and Budget and the

[[Page 30861]]

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. Through this office, 
the Deputy Inspector General for Management and Policy serves as the 
OIG Chief Information Officer.
    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 fraud, waste and abuse, 
and to promote economy, efficiency and effectiveness in HHS programs 
and operations.
    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 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. 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.
    B. The immediate office manages OEI's work planning process, and 
develops and reviews legislative, regulatory and program proposals to 
reduce 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 immediate office provides statistical and data base advice 
and services for inspections conducted by the regional offices. It 
carries out analyses of large data bases to identify potential areas of 
fraud and abuse, and provides technical assistance to the regional 
offices for these purposes. It operates a toll-free hotline for the OIG 
to permit individuals to call in suspected fraud or waste, refers the 
calls for appropriate action by HHS agencies or other OIG components, 
and analyzes the body of calls to identify trends and patterns of fraud 
and abuse needing attention.
    D. 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 Counsel to the Inspector General (OCIG), Civil Recoveries 
Branch. The office serves as a liaison with HCFA, State licensing 
boards and other outside organizations and entities with regard to 
exclusion, compliance and enforcement activities. It develops models 
for corporate integrity, compliance and enforcement programs; monitors 
ongoing compliance, exclusion, enforcement activities 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 OCIG, Civil Recoveries Branch. 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. The office coordinates with the Public Health 
Service to effectuate repayment agreements with those excluded 
individuals who have defaulted on HEAL loans.
    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.

[[Page 30862]]

    C. The office imposes CMPs and other assessments in accordance with 
the CMP law on those cases not handled by the OCIG, Civil Recoveries 
Branch, 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, refers material breaches of 
compliance plans to the OCIG, Civil Recoveries Branch for potential 
sanctioning.
    E. The office serves to increase industry awareness of corporate 
compliance issues by proactively promoting voluntary adoption of 
corporate compliance plans through speeches, articles, visits and other 
liaison activities with governmental and private sector groups, as well 
as developing model or best practice recommendations to be utilized by 
the health care industry.
    F. The office represents the OIG in coordinating all CMP actions 
initiated by other Federal health care programs that are authorized to 
prosecute health care providers. The office provides guidance and 
monitors all actions in this area until completion of these actions.
    Section AFG.00, Office of Counsel to the Inspector General (OCIG)--
Mission. The Office of Counsel to the Inspector General (OCIG) is 
responsible for providing all legal services and advice to the 
Inspector General, Principal Deputy Inspector General and all the 
subordinate components of the Office of Inspector General, in 
connection with OIG operations and administration, OIG fraud and abuse 
enforcement activities, and OIG activities designed to promote 
efficiency and economy in the Department's programs and operations. The 
OCIG is also responsible for litigating civil money penalty (CMP) and 
program exclusion cases within the jurisdiction of the OIG, for the 
coordination and disposition of False Claims Act qui tam and criminal, 
civil and administrative matters involving the Department of Justice 
(DoJ), and for the resolution of voluntary disclosure and program 
compliance activities.
    Section AFG.10, Office of Counsel to the Inspector General--
Organization. The office is directed by the Chief Counsel to the 
Inspector General, and the Assistant Inspector General for Legal 
Affairs. The office is comprised of the following components:
    A. Advice.
    B. Civil Recoveries.
    C. Administrative Litigation.
    D. Industry Guidance.
    Section AFG.20, Office of Counsel to the Inspector General--
Functions. A. Advice. This office provides legal advice to the various 
components of the OIG on legal issues that arise in the exercise of the 
OIG's responsibilities under the Inspector General Act of 1978. Such 
issues include the scope and exercise of the Inspector General's 
authorities and responsibilities; investigative techniques and 
procedures (including criminal procedure); the sufficiency and impact 
of legislative proposals affecting the OIG; and the conduct and 
resolution of investigations, audits and inspections. The office 
evaluates the legal sufficiency of OIG recommendations and develops 
formal legal opinions, in coordination with the HHS Office of the 
General Counsel, to support those recommendations. The office provides 
legal advice on OIG internal administration and operations, including 
appropriations, delegations of authority, ethics, OIG regulations, 
personnel matters, the disclosure of information under the Freedom of 
Information Act and the safeguarding of information under the Privacy 
Act. The office is responsible for conducting and coordinating 
litigation activities on personnel and Equal Employment Opportunity 
matters and Federal tort actions involving OIG employees. The office is 
responsible for the clearance and enforcement of subpoenas issued by 
the OIG, and defends the OIG in litigation matters as necessary.
    B. Civil Recoveries. This office oversees all False Claims Act 
cases, including qui tam cases, and handles final sign-off on False 
Claims Act settlements for the Department. It coordinates DOJ resource 
requests, participates in settlement negotiations and provides 
litigation support. 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 program exclusion 
liability. Where necessary, the office litigates appeals of program 
exclusions imposed in such cases before the Department Appeals Board 
(DAB) and assists DOJ in handling any subsequent appeals of such cases 
to the Federal courts. The office coordinates and resolves all 
voluntary disclosure cases through: (1) liaison activities with DOJ and 
the U.S. Attorney's office; (2) the disclosure verification efforts of 
OAS and OI; and (3) final disposition and sign-off of the matter. The 
office, in coordination with other OIG components, develops both the 
standards governing the use of program exclusion authorities in cases 
involving other Federal agencies, including DOJ, and the criteria for 
evaluating whether to impose program exclusions against health care 
providers in such cases. It is responsible for ensuring that all 
program exclusion actions not handled by OEC are promptly and 
accurately reported to the appropriate OIG data base. The office is 
responsible for developing and maintaining a comprehensive and 
coordinated data base on all settled and pending False Claims Act and 
CMP cases under its authority.
    C. Administrative Litigation. This office is responsible for 
providing legal advice to OEC concerning the legal sufficiency of 
proposed program exclusions, issues relating to the scope and effect of 
program exclusions, and the reinstatement of excluded persons or 
entities. The office assists OEC in developing standards governing the 
imposition of program exclusions. The office litigates appeals of 
program exclusions imposed by OEC before the DAB and assists DOJ in 
handling any subsequent appeals of such cases to the Federal courts. 
The office reviews all patient anti-dumping cases referred by the 
Health Care Financing Administration, makes recommendations regarding 
the handling of these cases, and negotiates settlements with hospitals 
and physicians of their liability for CMPs and program exclusions. 
Where appropriate, the office litigates CMPs and program exclusions 
imposed on hospitals and physicians for violations of the patient anti-
dumping statute. The office also reviews, negotiates settlements, and 
litigates other CMP cases that have been referred by OEC. In addition, 
the office provides legal advice to OEC on matters involving the 
development and monitoring of corporate compliance plans, the 
resolution of breaches of such plans, and the development of corrective 
action plans. The office also has primary responsibility for developing 
and promulgating all OIG sanction and interpretative regulations for 
codification into the Code of Federal Regulations, all OIG-related 
Federal Register notices, and the review and drafting of legislative 
proposals relating to fraud and abuse enforcement activities.
    D. Industry Guidance. This office is responsible for drafting and 
issuing advisory opinions to the health care industry and members of 
the public on whether an activity (or proposed

[[Page 30863]]

activity) would constitute grounds for the imposition of a sanction 
under the anti-kickback statute, the CMP law or the program exclusion 
authorities, and on other issues pertaining to the anti-kickback 
statute. The office develops and updates procedures for the submission 
of requests for advisory opinions and for determining the fees that 
will be imposed. The office solicits and responds to proposals for new 
regulatory safe harbors to the anti-kickback statute, modifications to 
existing safe harbors, and new fraud alerts. The office consults with, 
and obtains the concurrence of, DOJ on all proposed advisory opinions 
and safe harbors before issuance or publication. The office provides 
legal advice to the various components of the OIG, other offices of the 
Department, and DOJ concerning matters involving the interpretation of 
the anti-kickback statute and assists those components or offices in 
analyzing the applicability of the anti-kickback statute to various 
practices or activities under review.
    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 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. Included in 
this is the responsibility to track court ordered or agreed-to costs of 
audits recouped from health care providers found to have violated 
Medicare fraud and abuse program provisions. 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

[[Page 30864]]

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 programmatic and fraud and abuse oriented 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.
    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

[[Page 30865]]

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: May 15, 1997.
June Gibbs Brown
Inspector General.
[FR Doc. 97-14611 Filed 6-4-97; 8:45 am]
BILLING CODE 4150-04-P