Interpersonal group and collective behavior dynamics

Management - Organizational Behavior

DEPARTMENT of HEALTH and HUMAN SERVICES OFFICE of INSPECTOR GENERAL OFFICE of AUDIT SERVICES

Department of Health and Human Services (HHS) is this country's largest federal agencies with an annual budget that amounts to one quarter that of the entire federal budget and employs more than 60,000 individuals. Within the agency, its varied responsibilities are divided into major operating divisions, such as the Centers for Medicare and Medicaid Services (CMS), which administrates healthcare assistance to millions of beneficiaries; the National Institute of Health (NIH), which oversees medical and health-related research and funding; and the Food and Drug Administration (FDA), which monitors the quality of foods and drugs.

Within HHS, the Office of Inspector General (OIG) monitors all state and local agencies receiving federal funding provided in conjunction with all programs within the authority of HHS. The OIG comprises four separate organizational components: Office of Inspections and Evaluations (OIE); Office of Investigations (OI); Office of Counsel to the Inspector General (OCIG); and Office of Audit Services (OAS).

The HHS-OIG Office of Audit Services is the component organization of the Office of Inspector General responsible for auditing federal expenditures in connection with all federal funds or awards granted to state and local agencies, as well as private medical practitioners and equipment suppliers providing services to beneficiaries of HHS programs. The HHS-OIG-OAS headquarters is located in Washington, DC, and six other regional offices are located around the country. They are individually responsible for conducting audits of entities within their specific regions. Regional Inspector Generals for Audit Services (RIGAS) report to the Deputy Inspector General (DIG) in Washington, who in turn, reports to HHS Inspector General Dan Levinson.

At regional HHS-OIG-OAS offices, federal auditors perform audits of programs and institutions as selected by OAS managers in their annual audit plans in much the same way as Internal Revenue Services auditors conduct taxpayer audits. Within regional OAS offices, managers report to the Inspector General for Audit Services (RIGAS). Each manager maintains a staff of approximately 8 to 12 federal auditors who work in audit teams of 3 to 4 auditors, each. The work of HHS-OIG-OAS audit teams consists of targeting specific issues selected by their managers from the annual HHS-OIG-OAS audit plan, as assigned by each team's manager. Once an audit is planned, the audit team visits the offices of the auditee's facilities and examines all pertinent documentation, such as receipts and patient billing records. After the fieldwork is complete, the individual auditors analyze the data contained in the records and the team reassembles to report its conclusions and issue recommendations on different segments of the audit. Identified audit issues generate lawful instructions issued by the Inspector General requiring auditees to improve compliance where they are deficient and repay federal funds received or expended improperly. Generally, audit issues selected for review generate repayments in the millions of dollars per audit.

The work of HHS-OIG-OAS audit teams culminates in a formal audit report written by a writer in each regional office. Each HHS-OIG-OAS audit report undergoes a series of reorganization, refinement, changes, and edits before it is finally issued and signed by the Inspector General and released to the news media and the public.

Several years ago, the evolution of audit results into audit reports was not particularly efficient, because the various responsibilities in the process of developing results into written reports needed improvement. Each auditor drafted a portion of the report before review by a senior auditor; and then the senior auditor in each audit team revised and edited the draft section before another review by the audit manager.