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To help combat fraud and abuse in health care programs, Congress enacted the Health Care Fraud and Abuse Control (HCFAC) program as part of the Health Insurance Portability and Accountability Act of 1996 (HIPAA). HIPAA requires that the Depts. of Health and Human Services (HHS) and Justice (DoJ) issue a joint annual report to Congress on amounts deposited to and appropriated from the Fed. Hospital Insur. Trust Fund for the HCFAC program. This review assesses the extent to which HHS and DOJ: (1) took actions to address the recommendations made in a 2005 report; and (2) designed effective controls over reporting HCFAC deposits and expenditures for FY 2008 and 2009. Charts and tables. This is a print on demand report.
Health Care Fraud and Abuse Control Program: Improvements Needed in Controls over Reporting Deposits and Expenditures
Audits provide essential accountability and transparency over government programs. Given the current challenges facing governments and their programs, the oversight provided through auditing is more critical than ever. Government auditing provides the objective analysis and information needed to make the decisions necessary to help create a better future. The professional standards presented in this 2018 revision of Government Auditing Standards (known as the Yellow Book) provide a framework for performing high-quality audit work with competence, integrity, objectivity, and independence to provide accountability and to help improve government operations and services. These standards, commonly referred to as generally accepted government auditing standards (GAGAS), provide the foundation for government auditors to lead by example in the areas of independence, transparency, accountability, and quality through the audit process. This revision contains major changes from, and supersedes, the 2011 revision.
Policymakers and program managers are continually seeking ways to improve accountability in achieving an entity's mission. A key factor in improving accountability in achieving an entity's mission is to implement an effective internal control system. An effective internal control system helps an entity adapt to shifting environments, evolving demands, changing risks, and new priorities. As programs change and entities strive to improve operational processes and implement new technology, management continually evaluates its internal control system so that it is effective and updated when necessary. Section 3512 (c) and (d) of Title 31 of the United States Code (commonly known as the Federal Managers' Financial Integrity Act (FMFIA)) requires the Comptroller General to issue standards for internal control in the federal government.
FISCAM presents a methodology for performing info. system (IS) control audits of governmental entities in accordance with professional standards. FISCAM is designed to be used on financial and performance audits and attestation engagements. The methodology in the FISCAM incorp. the following: (1) A top-down, risk-based approach that considers materiality and significance in determining audit procedures; (2) Evaluation of entitywide controls and their effect on audit risk; (3) Evaluation of general controls and their pervasive impact on bus. process controls; (4) Evaluation of security mgmt. at all levels; (5) Control hierarchy to evaluate IS control weaknesses; (6) Groupings of control categories consistent with the nature of the risk. Illus.
Catalog of reports, decisions and opinions, testimonies and speeches.