Skip to main content

Federal Bureau of Investigation: Accountability over the HIPAA Funding of Health Care Fraud Investigations Is Inadequate

GAO-05-388 Published: Apr 22, 2005. Publicly Released: May 16, 2005.
Jump To:
Skip to Highlights

Highlights

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) provided, among other things, funding by transfer to the Federal Bureau of Investigation (FBI) to carry out specific purposes of the Health Care Fraud and Abuse Control Program. Congress expressed concern about a shift in FBI resources from health care fraud investigations to counterterrorism activities after September 11, 2001. Congress asked GAO to review FBI's accountability for the funds transferred under HIPAA for fiscal years 2000 through 2003. GAO determined (1) whether FBI had an adequate approach for ensuring the proper use of the HIPAA transfers and (2) the extent to which FBI had expended these transferred funds on health care fraud investigations in fiscal years 2000 through 2003.

Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Federal Bureau of Investigation The Director of the FBI should develop formal, interim policies and procedures for reporting health care fraud investigation costs that specify (1) the costs to be estimated and/or allocated, (2) the supporting documentation to be maintained, and (3) the method to validate those data used.
Closed – Implemented
The FBI agreed with our recommendation. In October 2013, the FBI implemented the Unified Financial Management System (UFMS), which allows it to track and monitor health care fraud investigation costs in the aggregate and for each FBI office. With the implementation of these cost tracking capabilities in UFMS, we believe these system improvements have superseded the need for interim measures and, therefore, the intent of this recommendation has been met.
Federal Bureau of Investigation The Director of the FBI should periodically conduct statistically valid testing of the data in the Time Utilization and Record Keeping (TURK) system, in particular, the work time percentages and related investigative classification information to ensure the TURK system's reliability. In addition, require field office managers to follow up on any issues identified in the testing.
Closed – Implemented
FBI established a semiannual audit of TURK in FY 2006 and required the correction of any errors discovered. This audit satisfies the recommendation.
Federal Bureau of Investigation The Director of the FBI should either specify that the Unified Financial Management System (UFMS) have the capability to allocate payroll costs provided by the National Finance Center (NFC) payroll system to specific programs or develop cost accounting codes at the program and subprogram levels to enable NFC to provide the necessary detailed payroll reports.
Closed – Implemented
The FBI agreed with this recommendation. In response, the FBI implemented the Unified Financial Management System in October 2013, which included unique identifiers the FBI can use to identify payroll costs in the aggregate and for each FBI office.
Federal Bureau of Investigation The Director of the FBI should ensure that the UFMS has the capability and design specifications to track nonpersonnel costs related to health care fraud investigations.
Closed – Implemented
The FBI agreed with this recommendation. In response, the FBI implemented the Unified Financial Management System in October 2013, which included unique identifiers the FBI can use to identify nonpersonnel costs in the aggregate and for each FBI office.

Full Report

Office of Public Affairs

Topics

AccountabilityCost analysisFederal fundsFederal lawFederal regulationsFinancial managementFraudFunds managementInternal controlsInvestigations by federal agenciesMonitoringHealth care fraudCost estimatesFunds transfer