[Federal Register Volume 83, Number 215 (Tuesday, November 6, 2018)]
[Notices]
[Pages 55553-55556]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-23935]
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DEPARTMENT OF HEALTH AND HUMAN SERVICES
Office of Inspector General
[OIG-1810-N]
Statement of Organization, Functions, and Delegations of
Authority
AGENCY: Office of Inspector General (OIG), HHS.
ACTION: Notice.
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SUMMARY: This notice replaces all language in Part Q (Office of the
Secretary) of the Statement of Organization, Functions, and Delegations
of Authority for the Department of Health and Human Services (HHS or
the Department), Office of Inspector General (OIG) (81 FR 13807, as
published March 15, 2016).
The Statement of Organization, Functions, and Delegations of
Authority conforms to and carries out the statutory requirements for
operating OIG. The organizational changes reflected in this notice are
primarily to realign the functions within OIG to better reflect the
current work environment and priorities and to more clearly delineate
responsibilities for the various activities within OIG's offices.
OIG was established by law as an independent and objective
oversight unit of the Department to carry out the mission of preventing
fraud and abuse and promoting economy, efficiency, and effectiveness of
HHS programs and operations. In furtherance of this mission, the
organization:
Conducts and supervises audits, investigations,
evaluations, and inspections relating to HHS programs and operations;
identifies systemic weaknesses giving rise to
opportunities for fraud and abuse in HHS programs and operations and
makes recommendations to prevent their recurrence;
leads and coordinates activities to prevent and detect
fraud and abuse in HHS programs and operations;
detects wrongdoers and abusers of HHS programs and
beneficiaries so appropriate remedies may be brought to bear, including
imposing administrative sanctions against providers of health care
under Medicare and Medicaid who commit certain prohibited acts; and
keeps the Secretary of Health and Human Services and
Congress fully and currently informed about problems and deficiencies
in the administration of HHS programs and operations and about the need
for and progress of corrective action.
In addition, OIG works with the Department of Justice (DOJ), on
behalf of the Secretary, to operate the Health Care Fraud and Abuse
Control Program. In accordance with authority enacted in its annual
appropriations, OIG also provides protection services to the Secretary
and conducts criminal investigations of violations of Federal child
support provisions.
In support of its mission, OIG carries out and maintains an
internal quality assurance system and a peer-review system with other
Offices of Inspector General, 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, are effective, and are functioning as
intended in OIG operations.
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Section Q, Office of Inspector General--Organization
There is at the head of OIG a statutory Inspector General,
appointed by the President and confirmed by the Senate. OIG consists of
six organizational units:
1. Immediate Office of the Inspector General (QA)
2. Office of Management and Policy (QC)
3. Office of Evaluation and Inspections (QE)
4. Office of Counsel to the Inspector General (QG)
5. Office of Audit Services (QH)
6. Office of Investigations (QJ)
Section Q, Office of Inspector General--Functions
The component sections that follow describe the specific functions
of the organization.
Section QA.00, Immediate Office of the Inspector General--Mission
The Immediate Office of the Inspector General is directly
responsible for meeting the statutory mission of 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.
Section QA.10, Immediate Office of the Inspector General--Organization
The Immediate Office comprises the Inspector General, Principal
Deputy Inspector General, Chief of Staff, several technical advisors,
including the Chief Medical Officer, and staff.
Section QA.20, Immediate Office of the Inspector General--Functions
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. The Inspector General does not
report to and is not subject to supervision by any other officer in the
Department. In keeping with the independence conferred by the Inspector
General Act, the Inspector General assumes and exercises, through line
management, all functional authorities related to the administration
and management of 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
OIG, sets OIG policies and priorities, oversees OIG operations, and
provides reports to the Secretary and Congress. By statute, the
Inspector General exercises general personnel authority, e.g.,
selection, promotion, and 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 OIG, and during the
absence of the Inspector General, acts as the Inspector General. The
Principal Deputy Inspector General supervises the Chief Counsel to the
Inspector General, the Deputy Inspectors General, who head the major
OIG components, as well as the Chief of Staff.
The Immediate Office interacts with the Department, Congress, and
the public and leads OIG's congressional, media, and public affairs
functions. The office also plans, conducts, and participates in a
variety of interagency cooperative projects and undertakings relating
to fraud and abuse with the DOJ, the Centers for Medicare & Medicaid
Services (CMS), and other governmental agencies, and is responsible for
the reporting and legislative functions required by the Inspector
General Act.
Section QC.00, Office of Management and Policy--Mission
The Office of Management and Policy (OMP) provides management,
guidance, and resources in support of OIG.
Section QC.10, Office of Management and Policy--Organization
OMP is directed by the Deputy Inspector General for Management and
Policy, who, aided by Assistant Inspectors General, assures that OIG
has the financial and administrative resources necessary to fulfill its
mission. This office carries out its responsibilities through
headquarters functions.
Section QC.20, Office of Management and Policy--Functions
The staffs within OMP are responsible for formulating and executing
OIG's budget, developing policy, and managing information technology,
human resources, executive resources, procurement activities, and
physical space. OMP also executes and maintains an internal quality
assurance system, which includes quality control reviews of its
processes and products to ensure that OIG policies and procedures are
followed and function as intended. OMP provides centralized services
and management to deliver to OIG data, tools, skills, and support to
use data and data analytics. Finally, OMP coordinates organizational
performance management activities.
Section QE.00, Office of Evaluation and Inspections--Mission
The Office of Evaluation and Inspections (OEI) is responsible for
conducting indepth evaluations of HHS programs, operations, and
processes to identify vulnerabilities and recommend corrective action;
to prevent and detect fraud and abuse; and to promote efficiency and
effectiveness in HHS programs and operations. OEI conducts its work in
accordance with the Quality Standards for Inspection and Evaluation
issued by the Council of the Inspectors General on Integrity and
Efficiency.
Section QE.10, Office of Evaluation and Inspections--Organization
OEI is directed by the Deputy Inspector General for the Office of
Evaluation and Inspections who, aided by Assistant Inspectors General,
is responsible for carrying out OIG's responsibilities to evaluate the
effectiveness and efficiency of HHS programs and operations. The office
is comprised of headquarters and regional functions.
Section QE.20, Office of Evaluation and Inspections--Functions
OEI is responsible for conducting evaluations of HHS programs;
conducting data and trend analysis; and recommending changes in
programs, procedures, policies, regulations, and legislation. OEI
develops evaluation policies, procedures, techniques, and guidelines to
be followed by all OEI staff in conducting evaluations. The office
maintains an internal quality assurance program. OEI also oversees the
activities of State Medicaid Fraud Control Units (MFCUs) to ensure the
MFCUs' compliance with Federal grant regulations, administrative rules,
and performance standards for the purpose of certifying or recertifying
the MFCUs annually. The office also maintains automated data and
management information systems used by all OEI employees, a quality
assurance/peer-review program, and policy and procedure manuals.
Section QG.00, Office of Counsel to the Inspector General--Mission
In accordance with section 3(g) of the Inspector General Act (5
U.S.C. App. Sec. 3(g)), the Office of Counsel to the Inspector General
(OCIG) provides all legal advice to OIG and represents OIG in
administrative litigation. OCIG proposes and litigates civil money
[[Page 55555]]
penalty (CMP) and program exclusion cases within the jurisdiction of
OIG. It coordinates False Claims Act matters involving HHS programs and
resolves voluntary disclosure cases. OCIG develops guidance to assist
providers in establishing compliance programs; monitors ongoing
compliance of providers subject to integrity agreements; and promotes
industry awareness through advisory opinions, fraud alerts, and special
advisory bulletins.
Section QG.10, Office of Counsel to the Inspector General--Organization
OCIG is directed by the Chief Counsel to the Inspector General, who
also serves as OIG's Deputy Ethics Officer and is aided by Assistant
Inspectors General. The office carries out its responsibilities through
headquarters functions.
Section QG.20, Office of Counsel to the Inspector General--Functions
OCIG provides legal advice to OIG on issues that arise in the
exercise of OIG's responsibilities under the Inspector General Act of
1978, as amended. 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 OIG and HHS;
and the conduct and resolution of investigations, audits, and
inspections. The office evaluates the legal sufficiency of OIG findings
and recommendations and develops formal legal opinions to support these
findings and recommendations. The office also provides legal advice on
OIG internal administration and operations, including appropriations,
procurement, delegations of authority, OIG regulations, personnel
matters, disclosure of information under the Freedom of Information Act
(FOIA), and safeguarding information under the Privacy Act.
Additionally, OCIG coordinates OIG's regulatory review functions
required by the Inspector General Act and responses to all requests
made under FOIA. The office is responsible for the clearance and
enforcement of OIG subpoenas.
The office represents OIG in administrative litigation and related
appeals. This includes representing OIG in personnel and Equal
Employment Opportunity matters; coordinating OIG's representation in
Federal tort actions involving OIG employees; and representing OIG in
bid protests before the Government Accountability Office and the U.S.
Court of Federal Claims.
OCIG also determines whether to propose or implement administrative
sanctions, including CMPs and assessments within OIG's jurisdiction.
The office litigates and resolves all appealed or contested exclusions
from participation in Federal health care programs under the Social
Security Act. In conjunction with DOJ, the office represents HHS in all
False Claims Act cases, including qui tam cases, and is responsible for
final approval of civil False Claims Act settlements for the
Department, including the resolution of the program exclusion
authorities that have been delegated to OIG.
In conjunction with the Office of Investigations, OCIG coordinates
resolution of all voluntary and mandatory disclosure under OIG's
Provider Self-Disclosure Protocol, the contractor self-disclosure
requirement and otherwise. OCIG develops and monitors corporate and
individual integrity agreements adopted in connection with settlement
agreements, conducts onsite reviews, and develops audit and
investigative review standards for monitoring such integrity agreements
in conjunction with other OIG components. The office also resolves
breaches of integrity agreements through the development of corrective
action plans and the imposition of sanctions.
Finally, OCIG issues advisory opinions to the health care industry
and members of the public on whether a current or proposed activity
would constitute grounds for the imposition of a sanction under the
anti-kickback statute, the CMP law, or the program exclusion
authorities. The office develops procedures for submitting and
processing requests for advisory opinions and for determining the fees
that will be imposed. It solicits and responds to proposals for new
regulatory safe harbors to the anti-kickback statute, modifications to
existing safe harbors, and new fraud alerts. OCIG consults with DOJ on
proposed advisory opinions and safe harbors before issuance or
publication. The office provides legal advice to the components of OIG,
other HHS offices, and DOJ concerning matters involving the
interpretation of the anti-kickback statute and other legal
authorities, and assists those components or offices in analyzing the
applicability of the anti-kickback statute to particular practices or
activities under review.
Section QH.00, Office of Audit Services--Mission
The Office of Audit Services (OAS) is responsible for protecting
the integrity of HHS operations and programs by conducting audits that
identify and report ways to improve the economy, efficiency, and
effectiveness of operations and services to beneficiaries of HHS
programs and to help reduce fraud, waste, abuse, and mismanagement. OAS
conducts audits and oversees audit work performed by others. It
conducts its work in accordance with Government Auditing Standards and
follows applicable legal, regulatory, and administrative requirements.
Section QH.10, Office of Audit Services--Organization
OAS is directed by the Deputy Inspector General for Audit Services,
who, aided by Assistant Inspectors General, performs the functions
designated in section 3(d)(1)(A) of the Inspector General Act for the
position of Assistant Inspector General for Auditing. The office
comprises headquarters and regional functions and includes a designated
Whistleblower Protection Ombudsman, and the functions thereof, as
required by law (section 3(d)(1)(C) of the Inspector General Act).
Section QH.20, Office of Audit Services--Functions
OAS establishes audit priorities; performs audits; oversees the
progress of audits; coordinates with stakeholders on bodies of work;
recommends changes in program policies, regulations, and legislation to
prevent fraud, waste, and abuse and improve programs and operations;
and reports on the impact of audit work. The office develops audit
policies, procedures, techniques, and guidelines to be followed by all
OAS staff in conducting audits. OAS maintains an internal quality
assurance program, conducts peer reviews of other OIGs, and maintains
automated data and management information systems used by all OAS
employees. The office also provides oversight for audits of State and
local governments, universities, and nonprofit organizations conducted
by non-Federal auditors. OAS also provides education to agency
employees about prohibitions on retaliation, and the rights and
remedies against retaliation, for protected disclosures, as required of
the Whistleblower Protection Ombudsman.
Section QJ.00, Office of Investigations--Mission
The Office of Investigations (OI) is granted full statutory law
enforcement authority under the Homeland Security Act of 2003 (Pub. L.
107-296). OI is responsible for protecting the integrity of the
programs administered and/or
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funded by HHS by conducting criminal, civil, and administrative
investigations of fraud and misconduct related to HHS programs,
operations, and employees. The office serves as OIG's liaison to DOJ on
all matters relating to investigations of HHS programs and personnel
and reports to the Attorney General when there are reasonable grounds
to believe Federal criminal law has been violated. OI serves as a
liaison to CMS, State licensing boards, and other outside organizations
and entities with regard to exclusion, compliance, and enforcement
activities.
Section QJ.10, Office of Investigations--Organization
OI is directed by the Deputy Inspector General for Investigations,
aided by Assistant Inspectors General, and performs the functions
designated in the law (section 3(d)(1)(B) of the Inspector General Act)
for the position of Assistant Inspector General for Investigations. The
office is comprised of headquarters and regional functions.
Section QJ.20, Office of Investigations--Functions
OI conducts criminal, civil, and administrative investigations of
allegations of fraud, waste, abuse, mismanagement, and violations of
standards of conduct within the jurisdiction of OIG. OI establishes
investigative priorities, evaluates the progress of investigations, and
reports findings to the Inspector General. The office develops and
implements investigative techniques, programs, guidelines, and
policies; manages OI's quality assurance/peer-review program, and
conducts peer reviews of other OIGs. OI also 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. The office effectuates
mandatory and permissive exclusions from participation in Federal
health care programs under the Social Security Act; decides on all
requests for reinstatement from, or waiver of, exclusions; and
participates in developing standards governing the imposition of these
exclusion authorities. The office also oversees OIG's suspension and
debarment referral program. OI implements policies and procedures and
plans, develops, implements, and evaluates all levels of training for
OI employees. The staff provides for the personal protection of the
Secretary and other Department officials, as needed, and all emergency
operations preparedness and response. OI coordinates the adoption of
advanced digital forensic acquisition and examination and information
security technologies to assist in the investigation, prevention, and
detection of fraud and abuse; maintains an automated data and
management information system used by all OI employees; provides
technical expertise on computer applications for investigations; and
coordinates and approves investigative computer matches with other
agencies. In addition, the office operates a toll-free hotline to
permit individuals to report suspected fraud, waste, and abuse within
HHS programs.
Daniel R. Levinson,
Inspector General.
[FR Doc. 2018-23935 Filed 11-5-18; 8:45 am]
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