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Audit (A-06-09-00051)

07-06-2011
Review of Practitioner Compliance With the Requirements of the Hurricane Katrina Health-Care-Related Professional Workforce Supply Grant for the Greater New Orleans Area

Executive Summary

Based on our sample results for the period March 1, 2007, through January 31, 2009, we estimated that Louisiana's Bureau of Primary Care & Rural Health (the Bureau) paid at least $13.6 million of Federal grant funds to an estimated 509 practitioners who were not in compliance with Federal grant requirements. The Centers for Medicare & Medicaid Services (CMS) awarded Louisiana a $50 million Federal grant to restore access to health care in communities impacted by Hurricane Katrina. The grant funded payments to licensed health care professionals for retention and recruitment. Interested practitioners were required to submit applications for funding and sign contracts agreeing to, among other things, provide services for 3 years in the Greater New Orleans area and repay Federal grant funds with interest if the contract terms were breached.

Of the 100 practitioners included in our sample, 33 were in compliance with the Federal grant requirements, but 67, who received Federal grant funds totaling $3.2 million, were not. These errors occurred because the Bureau did not follow its existing policies and procedures or did not have adequate policies and procedures to ensure that its contracts with practitioners obligated them to meet the 3-year service requirements, that practitioners were monitored for compliance with the Federal grant requirements, and that corrective action was taken for practitioners not in compliance.

We recommended that the Bureau (1) refund to CMS $13.6 million for the estimated Federal grant funds paid to practitioners who were not in compliance with the Federal grant requirements during our audit period, (2) implement adequate policies and procedures to monitor practitioners' compliance with the Federal grant requirements, and (3) take corrective action for those practitioners not in compliance after our audit period. The Bureau disagreed with elements of two of our findings. Nothing in the Bureau's comments caused us to revise our findings or recommendations.

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