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Transcript for audio podcast: December 2013 OIG Monthly Update

From the Office of Inspector General of Department of Health and Human Services

[Brenda Tierney] Hello, I'm Brenda Tierney, audit manager in Albany, speaking with Glenn Richter, an audit manager from our Albany office about a report titled World Trade Center Health Program: CDC Should Strengthen Efforts to Monitor and Evaluate Clinic Compliance with Contract Terms. Glenn, can you tell us a little bit about the World Trade Center Health Program?

[Glenn Richter] Sure, Brenda. From 2002-2010, Congress provided money for medical treatment to eligible responders and survivors with health conditions related to the September 11, 2001, terrorist attacks. Congress distributed this money through grants and cooperative agreements.

[Brenda Tierney] In 2011, Congress passed legislation that transitioned from a grant-based to a contract-based approach for providing services. Why switch from grants to contracts?

[Glenn Richter] Switching to contracts should help establish greater accountability for administering the World Trade Center Health Program. In this new program, eight clinics in the New York/New Jersey Metropolitan Area provide medical services to September 11th responders and survivors. Two groups within the Centers for Disease Control and Prevention, or the CDC, oversee the contracts for these clinics.

[Brenda Tierney] What's the role of the two CDC groups?

[Glenn Richter] The first group is the Procurement and Grants Office. It determines how well clinics are performing. The second group is the National Institute for Occupational Safety and Health. It monitors and evaluates clinic performance and reports when a clinic deviates from contract terms and conditions.

[Brenda Tierney] So what aspect of the program did you focus on for your review?

[Glenn Richter] We focused on how CDC monitored and evaluated the clinics' compliance with contract terms and conditions, and Federal regulations. Through March of 2013, the clinics received more than $56 million dollars for operating expenses. They spent about $35 million dollars.

[Brenda Tierney] So Glenn, what did you find when you reviewed how CDC monitored the clinics' performance?

[Glenn Richter] We found three things. First, CDC did not use the required procedure to monitor the clinics. For example, instead of randomly monitoring how clinics reviewed claims data, CDC had meetings with clinic officials, and relied on the clinics' monthly progress reports. Second, CDC did not take timely or appropriate action when they learned that a clinic wasn't complying with its contract. Third, CDC didn't complete quarterly clinic evaluations - and - sometimes they didn't make evaluation results available to other Government agency contracting officers.

[Brenda Tierney] Why are these findings significant?

[Glenn Richter] The CDC and other Government agencies rely on monitoring and evaluation of contractors' performance. This helps agencies make informed business decisions when awarding and renewing Federal contracts. These monitoring activities are critical to ensure that the Federal Government does business with contractors that deliver quality goods and services - on time - and within budget.

[Brenda Tierney] What are you recommending that CDC do about this?

[Glenn Richter] We recommended that CDC monitor clinics' performance according to contract terms. It should also address clinics that aren't complying with contract terms as required by Federal regulations. Lastly, CDC should develop and implement standard operating procedures for evaluating contractor performance.

[Brenda Tierney] Has CDC agreed to do this?

[Glenn Richter] Yes. CDC agreed with all three of our recommendations and has begun to implement changes to how clinics are monitored.

[Brenda Tierney] Give us a look ahead. What additional work do you have planned in this area?

[Glenn Richter] In our next review, we plan to look at program claims to see if clinics are submitting only allowable costs for Federal reimbursement.

[Brenda Tierney] Thank you for sharing this important work. We look forward to your future audits.

[Glenn Richter] Thank you.


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