Audit of the Indian Health Service's Internal Controls Over Monitoring of Recipients' Compliance With Requirements of the Loan Repayment Program

Our review found that IHS did not have adequate internal controls to monitor recipients' compliance with certain requirements of the Loan Repayment Program. IHS did not always follow its policies and procedures to verify that recipients were employed at IHS-approved sites before awarding loan repayment funds and that recipients fulfilled their required service obligations. As a result, IHS could not ensure that all recipients were in compliance with Loan Repayment Program requirements. The purpose of the Loan Repayment Program is to ensure an adequate supply of trained health professionals to provide health care services to American Indians and Alaska Natives. Under the program, IHS is authorized to pay directly to the recipient of a loan repayment award the principal, interest, and related expenses on government and commercial loans obtained for an education in the health professions.

We recommended that IHS follow its policies and procedures to verify that recipients are employed before awarding loan repayment funds and that recipients fulfill their required service obligations. IHS concurred with our recommendation and described actions that it planned to take to address the recommendation.