Department of Health and Human Services 
OFFICE OF 
 
INSPECTOR GENERAL 
 
 
 
 
 
 
L P U
AW  S  ROHIBIT THE  SE OF 
 
HHS G F
  RANT  UNDS FOR 
 
 
L , L
OBBYING  BUT  IMITED 
 
 
M E T
ETHODS  XIST  O 
I N
DENTIFY  ONCOMPLIANCE 
 
Daniel R. Levinson   
Inspector General  
 
July 2014 
OEI-07-12-00620   
   
EXECUTIVE SUMMARY:  LAWS PROHIBIT THE USE OF HHS GRANT 
FUNDS FOR LOBBYING, BUT LIMITED METHODS EXIST TO IDENTIFY 
NONCOMPLIANCE  
OEI-07-12-00620 
 
WHY WE DID THIS STUDY 
 
This evaluation responded to a congressional request for the Office of Inspector General 
(OIG) to review grantees use of Department of Health and Human Services (HHS) funds 
and awarding agencies implementation and oversight regarding the prohibitions on the 
use of grant funds for lobbying. 
 
HOW WE DID THIS STUDY  
 
This evaluation included 13 grantmaking agencies (awarding agencies) within HHS.  We 
collected and reviewed departmental and awarding agency directives in place for fiscal 
years (FYs) 2011 and 2012.  We conducted structured telephone interviews with each 
agencys Chief Grants Management Officer and/or his or her designated staff.  We asked 
about awarding agencies notifications to grantees of the prohibitions on the use of grant 
funds for lobbying. We also asked about awarding agencies mechanisms for identifying 
grantees that may have violated lobbying prohibitions and the mechanisms in place for 
reviewing allegations of lobbying.  We conducted surveys with a sample of grantees from  
five awarding agencies regarding their awareness of the prohibitions. 
 
WHAT WE FOUND 
 
All awarding agencies reported using Federal and departmental sources of guidance 
regarding the prohibitions on the use of grant funds for lobbying.  Through grant 
applications, notices of award, and/or training, all awarding agencies informed grantees 
of the prohibitions. For all sampled grant awards, grantees reported being aware of the 
lobbying prohibitions. However, limited methods exist to identify noncompliance.  HHS 
awarding agencies found two instances of noncompliance in FYs 2011 and 2012. 
 
WHAT WE RECOMMEND  
 
We recommend that the Assistant Secretary for Financial Resources (ASFR) facilitate 
Departmentwide information sharing among awarding agencies about methods to identify 
the use of grant funds for prohibited lobbying activities.  We also recommend that ASFR 
centralize on its Web site the guidance pertaining to the prohibitions on the use of grant 
funds for lobbying. ASFR concurred with our recommendations. 
 
   
TABLE OF CONTENTS 
 
Objectives ....................................................................................................1 

Background..................................................................................................1 

Methodology................................................................................................8 

Findings......................................................................................................11 
 
All HHS awarding agencies reported using Federal and 

departmental guidance on the prohibitions on the use of grant 

funds for lobbying..........................................................................11
  
Through grant applications, notices of award, and/or training, all 

HHS awarding agencies informed their respective grantees 
 
of the prohibitions on the use of grant funds for lobbying ............12 

For all sampled grant awards, grantees reported being aware of 

the prohibitions on the use of grant funds for lobbying; a few 

grantees suggested the need for more guidance .............................13 

Limited methods exist to identify noncompliance with 

prohibitions on lobbying; HHS awarding agencies found two 

instances of noncompliance in FYs 2011 and 2012 .......................14 

Conclusion and Recommendations ............................................................17 

Agency Comments and Office of Inspector General Response .................18 

Appendixes ................................................................................................19 

A: Point Estimates and Confidence Intervals for Grantee 
 
Surveys...........................................................................................19 

B: Agency Comments  ...................................................................20 

Acknowledgments......................................................................................21 

   
   
OBJECTIVES 
To determine: 
1. 	  the policies, procedures, and guidance that awarding agencies within 
the Department of Health and Human Services (HHS) had in place 
regarding the prohibitions on the use of grant funds for lobbying 
activities; 
2. 	  the extent to which awarding agencies informed grantees of these 
prohibitions; 
3. 	  the extent to which grantees were aware of the prohibitions; and 
4. 	  the extent to which awarding agencies monitored grantees for 
compliance with the prohibitions and identified instances of 
noncompliance. 
BACKGROUND 
This evaluation responded to a congressional request for the Office of 
Inspector General (OIG) to review grantees use of HHS funds and 
awarding agencies implementation and oversight regarding the 
prohibitions on the use of grant funds for lobbying activities.   
HHS Grants 
HHS is the largest grantmaking agency in the Federal Government.  In 
fiscal year (FY) 2012, HHS operating divisions and staff divisions  
awarded nearly $347 billion in grants.  (We refer to grantmaking operating 
divisions and staff divisions collectively as awarding agencies.)  Table 1 
shows the number and dollar amount of grants that awarding agencies 
made in FY 2012. 
   
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  1 
(OEI-07-12-00620)  
   
   
Table 1:   FY 2012 Grant Awards by Awarding Agency  
Number of   Percentage  Dollar Amount  Percentage of 
Awarding Agency  
Awards  of Awards  of Awards  Dollar Amount 
Administration for Children and  
8,097  10%   $47,908,116,593   14%  
Families (ACF) 
Administration for Community  
1,470  2%   $1,461,721,177   <1%  
Living (ACL)  
Agency for Healthcare Research 
641  <1%   $138,004,180   <1%  
and Quality  (AHRQ)  
Centers for Disease Control and 
4,654  6%   $4,993,308,851   1%  
Prevention (CDC)  
Centers for Medicare & Medicaid 
1,472  2%   $256,600,245,678  74%  
Services (CMS)* 
Food and Drug Administration 
462  <1%   $114,070,061   <1%  
(FDA)  
Health Resources and Services 
5,759  7%   $7,544,435,173   2%  
Administration (HRSA)  
Indian Health Service (IHS)   1,009   1%   $2,328,004,693   <1%  
National Institutes of Health (NIH)   54,674   67%   $22,244,072,528   6%  
Office of the Secretary**   607  <1%   $462,607,574   <1%  
Substance Abuse and Mental 
Health Services Administration  2,909  4%   $3,187,756,086   <1% 
(SAMHSA) 
   Total   81,754   100%   $346,982,342,594  100%  
Note: Percentages do not sum to 100 percent  because of rounding. 

*Includes approximately $254 billion of grants to States from Medicaid and  the Childrens Health Insurance Program. 

**Includes staff divisions,  such  as the Office  of the  Assistant Secretary for Health, the Office of the Assistant Secretary for Preparedness 

and Response (ASPR), and the Office of the National Coordinator  for Health Information Technology. 

Source:  Tracking Accountability in Government Grants System.  Accessed on May 14, 2013 at  http://taggs.hhs.gov. 

 
Within the Office of the Secretary,  the Assistant Secretary for Financial 
Resources (ASFR) serves as the lead official for grants.  Within ASFR, the 
Office of Grants and Acquisition Policy and Accountability (OGAPA) 
provides Departmentwide leadership and management in the areas of 
grants and acquisition management through policy development, data 
systems operations and analysis, performance measurement, oversight and  
workforce training, development, and certification.  OGAPA: 
 
   develops departmental regulatory guidance, policies, and 
performance standards;  
   provides technical assistance to awarding agencies;  
   evaluates effectiveness of the grants programs and processes;  
   maintains and reports departmental grant award information; and  
   conducts special departmental initiatives related to grants.1    
 
1 HHS, Office of the Assistant Secretary for Financial Resources Functional Statement.   
Accessed at http://www.hhs.gov/asfr/about/orginfo/ 
asrtfunctions.html#AMT_Off_Grants_Acquisition on  July 9, 2012. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  2 
(OEI-07-12-00620)  
   
   
Additionally, individual awarding agencies maintain staff dedicated to 
grants administration.   
Federal Laws and Regulations Regarding Lobbying 
Prohibitions 
Federal laws address general restrictions on direct and indirect lobbying.2    
Direct lobbying occurs when an individual or a group directly contacts 
legislators either in person or by means of written or oral communication 
to support or oppose some legislative matter. Indirect or grassroots 
lobbying occurs when an individual or group contacts third parties and 
urges them to contact their legislators to support or oppose some  
legislative matter.  In addition to the restrictions on direct or indirect 
lobbying, there are lobbying-related appropriations restrictions on 
publicity or propaganda.3  Finally, Federal regulations require grantees to 
make certifications about their lobbying activities in certain 
circumstances.4  Further details of each of these legal provisions are 
described below.  
Federal Laws. There are two codified Federal laws that pertain to the 
prohibitions on the use of grant funds for lobbying.  First, 
18 U.S.C.  1913 prohibits the use of Federal funds to lobby unless 
expressly authorized by law.5 It provides that no Federal appropriations 
may be used directly or indirectly  
 
to influence in any manner a Member of Congress, a 
jurisdiction, or an official of any government, to favor, 
adopt, or oppose, by vote or otherwise, any legislation, 
law, ratification, policy or appropriation, whether before 
or after the introduction of any bill, measure, or resolution 
proposing such legislation, law ratification, policy or 
appropriation. . . . 
 
Second, 31 U.S.C.  1352 prohibits recipients of Federal grants from using 
Federal appropriations to influence Federal officials in connection with the 
grant award process (e.g., awarding or extending a grant).   
 
2 18  U.S.C.   1913;  31 U.S.C.  1352; and see, e.g., Departments of Labor, HHS, and  
Education, and Related Agencies Appropriations Act, 2012, P.L. No. 112-74, Div.  F, 
Title V,  503.  
3 See, e.g., Departments of Labor, HHS, and Education, and Related Agencies 
Appropriations Act, 2012, P.L. No. 112-74,  Div. F, Title V,  503(a). 
4 45 CFR pt. 93. 
5 We understand  that although there are differing interpretations of the scope of the 
2002 amendments to 18  U.S.C.  1913, the Department considers the provision to  
continue to apply only to executive agencies and not to  have been affirmatively extended  
to grantees, contractors, or other recipients of funds from  agencies. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  3 
(OEI-07-12-00620)  
   
   
Annual Appropriations Acts. Appropriations acts authorize Federal 
agencies to incur obligations and make payments for specified purposes.6   
HHS programs and activities are generally funded through a number of 
appropriations. For many years, the annual HHS fiscal year 
appropriations act stated: No part of any appropriation contained in this 
Act shall be used to pay the salary or expenses of any grant or contract 
recipient, or agent acting for such recipient, related to any activity 
designed to influence legislation or appropriations pending before the 
Congress or any State legislature. 7   The FY 2012 Labor, HHS, and 
Education Appropriations  Act (hereafter in this report referred to as 
FY 2012 HHS Appropriation) broadened the scope of these appropriation 
restrictions and prohibits the use of Federal funds to grantees, or their 
agents  
   
related to any activity designed to influence the enactment 
of legislation, appropriation, regulation, administrative 
action or Executive order proposed or pending before the 
Congress or any State government, State legislature or local 
legislature or legislative body other than for normal and 
recognized executive-legislative relationships or 
participation by an agency or officer of a State, local or  
tribal government in policymaking and administrative 
processes within the executive branch of that government.8  
 
The FY 2012 HHS Appropriation also broadened the restrictions to 
include any activity to advocate or promote any requirement or restriction 
on any legal consumer product.9  
The Labor, HHS, and Education Appropriations Act provides funding for 
many HHS programs, but not all of them.  For example, the Interior and 
Environment Appropriations Act appropriates funds for IHS, the National 
Institute of Environmental Health and Sciences within NIH, and the 
Agency for Toxic Substances and Disease Registry within CDC.  Funds 
appropriated in this  Act are unavailable for any activity or the publication 
or distribution of literature that in any way tends to promote public support 
 
6 Government Accountability Office (GAO), Principles of  Federal Appropriations Law, 

GAO-04-261SP, Appropriations Law 3rd ed., Vol.  1, pp.  25, 2004. 
 
7 E.g.,  P.L. No. 111-117, Div. D, Title  V,  503(b) (Dec. 16, 2009). 

8 P.L. No. 112-74, Div. F, Title V,  503(b) (Dec. 23, 2011). 

9 P.L. No. 112-74, Div. F, Title V,  503(c) (Dec. 23, 2011). 

Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  4 
(OEI-07-12-00620)  
   
   
or opposition to any legislative proposal on which Congressional action is 
not complete. . . .10   
In addition, the Agriculture, Rural Development, Food and Drug 
Administration, and Related Agencies Appropriations Act provides 
appropriations for FDA.11  Unlike funds from the general HHS 
appropriations, funds appropriated in this Act do not have any 
appropriation-specific lobbying restrictions.  All other lobbying 
restrictions generally still apply to FDA appropriations. 
Governmentwide restrictions on lobbying are also included in an annual 
appropriations act.12   These restrictions apply to funds specifically 
appropriated in the particular appropriation act as well as any other Act. 
Federal Regulations.  On the basis of 31 U.S.C.  1352, Federal 
regulations at 45 CFR pt. 93 require an applicant for a grant exceeding 
$100,000 to certify that no federally appropriated funds have been or will 
be paid to any Federal official in connection with the making, extending, 
continuing, renewing, amending, or modifying of a Federal grant.  After 
the award of a grant, if a grantee uses nonappropriated funds to influence 
the grant-awarding process or in a way that materially affects the accuracy 
of the information provided in the certification, the grantee must submit 
Standard Form LLL, Disclosure of Lobbying Activities. 
Federal regulations at 45 CFR pts. 74 and 92 establish uniform 
administrative requirements governing HHS grants to (1) institutions of 
higher education, hospitals, and other nonprofit organizations and (2) to 
State, local, and tribal governments, respectively. Federal regulations 
(45 CFR  74.27 and 92.22) incorporate by reference the Federal cost 
principles in the Office of Management and Budget (OMB) circulars that 
   
 
10 P.L. No.  111-88, Div. A, Title IV,  402 (Oct. 30, 2009), and P.L. No. 112-74, Div. E, 
Title IV,  402 (Dec. 23, 2011). 

11 See  P.L. No. 111-80, Title VI (Oct. 21, 2009); P.L. No. 112-55, Div.  A, Title VI 
 
(Nov. 18, 2011). 

12 See P.L. No. 111-117, Div. C, Title VII,  717 (Dec. 16, 2009), and P.L. No. 112-74, 

Div. C, Title VII,   716 and  719  (Dec. 23, 2011). 

Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  5 
(OEI-07-12-00620)  
   
   
restrict the use of Federal grant funds for costs incurred as a result of 
prohibited lobbying activities. 13  
HHS Guidance Regarding Lobbying Prohibitions  
The HHS Grants Policy Directives (GPD) and the Awarding Agency 
Grants Administration Manual (AAGAM) are HHS internal policies 
applicable to awarding agencies, but not to grantees.14 The HHS Grants 
Policy Statement (GPS) describes the general terms and conditions of 
HHS discretionary grant awards and is applicable to most grantees.15  
Grants Policy Directives. The GPD provides guidance on 
grants-management issues to affected program offices at all organizational 
levels within the Department and is the highest level of departmental 
grants-policy issuance within the Department.  With respect to the 
prohibitions of using grant funds for lobbying activities, the GPD 
references 45 CFR pt. 93 and the OMB circulars.16    
AAGAM. The AAGAM implements the GPD by providing detailed 
guidance to awarding agency staff involved in grants administration.  With 
respect to the prohibitions on using grant funds for lobbying, the AAGAM 
references 18 U.S.C  1913, 31 U.S.C.  1352, appropriations act 
language, and the applicable Federal cost principles in the OMB 
circulars.17  In addition, the AAGAM requires that each award include 
general terms and conditions that address the post-award requirements of 
applicable public policies, including those related to lobbying.18  
GPS. The GPS describes general terms and conditions that are included in 
all HHS discretionary grant awards unless there are statutory, regulatory,  
or award-specific requirements to the contrary.  The GPS refers to the 
lobbying limitations in 31 U.S.C.  1352, which prohibit grantees from  
 
13 OMB Circulars A-21  (regarding educational institutions); A-87 (regarding State, local, 

and  tribal governments);  and A-122 (regarding  nonprofit  organizations).  The lobbying
  
provisions in these three circulars are codified at 2 CFR pt.  220, App.  A,  28; 
 
2  CFR pt. 225, App. B,  24(a)  and (b);  and 2  CFR pt. 230, App. B,  25(a) 15, 

respectively. These requirements have  been superseded and streamlined by OMB 

guidance that will largely become effective for all Federal awards or funding  increments 

provided on or after December 26, 2014 (78 Fed. Reg. 78590 (Dec. 26, 2013)).  The new 

lobbying provision is at 2 CFR   200.450. 

14 Ch. 1.01.101-2  of the AAGAM states that the AAGAM must be used  by any awarding 
 
agency that is  not  developing and maintaining its own grants administration manual. 
  
Currently, NIH is the only awarding agency with its own  grants administration manual 

and therefore does not use the AAGAM.  HHS departmental grants  guidance is  being 

updated to  become a new Grants Policy and Administration Manual. 

15 In  1998, NIH issued the first version of its own NIH Grants Policy Statement 

(NIHGPS).  Therefore, the HHS GPS does  not apply to  NIH. 
 
16 HHS, GPD,  1.01H.2 and H.3. 
  
17 HHS, AAGAM, ch. 6.99.101-2.B.7, and Attachment 1. 
 
18 HHS, AAGAM, ch.  2.04.104D-3.A.5.c(9). 

Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  6 
(OEI-07-12-00620)  
   
   
influencing Federal officials in connection with the grant awards.  The 
GPS describes the implementing regulations at 45 CFR pt. 93 that state 
that applicants for grants with total costs expected to exceed $100,000 are 
required to certify that they (1) have not made, and will not make, such a 
prohibited payment (i.e., for lobbying activities); (2) will be responsible 
for reporting the use of nonappropriated funds for such purposes; and 
(3) will include these requirements in consortium agreements, other 
subawards, and contracts under grants that exceed $100,000 and will 
obtain necessary certifications from those consortium participants and 
contractors.19  In addition, the GPS states that lobbying is generally an 
unallowable cost, includes general restrictive language found in HHS 
appropriations, and references the Federal cost principles in the OMB 
circulars.20  
Awarding Agency Guidance Regarding Lobbying Prohibitions 
Awarding agencies may publish their own guidance to grantees in various 
formats.  For example, NIH publishes its own GPS, which contains the 
policy requirements that serve as the terms and conditions of NIH grant 
awards. CDC maintains a list of Additional Requirements (delineated 
by number) that may apply to a funding opportunity.21   Additional 
Requirement 12 addresses the prohibition of using CDC funds to engage 
in any lobbying activity.  
Awarding Agency Staff Roles and Responsibilities 
The GPD outlines the primary responsibilities of the awarding agency 
staff involved in the award and management of HHS grants.22  
Chief Grants Management Officer (CGMO). Each awarding agency head 
must designate an individual to serve as the official responsible for the 
business and nonprogrammatic management aspects of the awarding 
agencys grants.  The CGMO is the appointing authority for additional 
grants management officers (GMOs) within the awarding agency.   
GMO. A GMO is responsible for all Federal business management 
matters associated with the review, negotiation, award, and administration 
of the grants to which he/she is assigned.  GMOs also interpret 
grants-administration policies and provisions and are responsible for 
maintaining the official grant files for individual grant awards.  The GPS 
 
19  HHS GPS, p. I-15.  Accessed online  on September 24, 2012;  link has  since changed to
  
http://www.hhs.gov/asfr/ogapa/aboutog/hhsgps107.pdf. 

20 Ibid., II-35.  

21 CDC, Additional Requirements. Accessed at 

http://www.cdc.gov/od/pgo/funding/grants/additional_req.shtm on September 17, 2012. 
  
There were 32  additional requirements as of that date.  

22 HHS, GPD,  1.04. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  7 
(OEI-07-12-00620)  
   
   
advises grantees to seek advance understanding with their respective 
GMOs on any activities directly related to the performance of the grant 
that might otherwise be considered lobbying activities.23  
Related Report 
In 2013, GAO issued a report regarding CDCs Communities Putting 
Prevention to Work (CPPW) cooperative agreement program.24 GAO 
reviewed CDC policies on lobbying and reviewed activities by CPPW  
award recipients. CDC used funding-opportunity announcements and 
meetings with CPPW award recipients to educate them on lobbying 
policies. The report described two CPPW award recipients that were 
suspected of conducting prohibited activities.  One of the two recipients 
was found to be conducting activities that constituted lobbying under 
CDCs policy.  
METHODOLOGY 
This evaluation examined 13 awarding agencies.25  We relied on three data 
sources for this evaluation: (1) awarding agency documents and data, 
(2) structured interviews with CGMOs, and (3) surveys of grantees.   
Awarding Agency Data Request 
We asked awarding agencies to provide us with departmental and/or 
awarding agency guidance regarding prohibitions on the use of grant funds 
for lobbying during FYs 2011 and 2012.  We requested the standard 
language that each awarding agency used to describe lobbying restrictions 
in FY 2012 applications and notices of grant awards.  Lastly, we requested 
the number and description of documented instances of noncompliance 
with the prohibitions on the use of grant funds for lobbying activities 
identified in FYs 2011 and 2012. 
Structured Interviews With CGMOs  
We conducted structured telephone interviews with CGMOs from  
13 awarding agencies.26   We asked about awarding agencies notifications 
to grantees of the prohibitions on the use of grant funds for lobbying.  We  
also asked about awarding agencies mechanisms for identifying grantees 
that may have violated lobbying prohibitions. 
 
23  HHS GPS, p. II-35.   (See footnote 19  for  URL.)  
24 GAO,  Centers for Disease Control and  Prevention:  Lobbying Policies and Monitoring  
for Program to Reduce Obesity and Tobacco  Use, GAO-13-477R, April 30, 2013. 
25 The 13 awarding agencies consisted of  10 operating divisions (ACF, ACL, AHRQ, 
CDC, CMS, FDA,  HRSA, IHS, NIH, and  SAMHSA) and 3 staff divisions in the Office 
of the Secretary (the Office of the Assistant Secretary for Health, ASPR, and the  Office  
of the National Coordinator  for Health Information Technology). 
26 CGMOs have  oversight  responsibility for GMOs; therefore, CGMOs should have  
knowledge of awarding-agency enforcement actions. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  8 
(OEI-07-12-00620)  
   
   
Grantee Surveys 
In FY 2012, the top five awarding agencies for numbers of grants awarded 
were ACF, CDC, HRSA, NIH, and  SAMHSA.  These awarding agencies 
awarded 94 percent of the total number of HHS grant awards.27 ASFR 
provided us with data (e.g., grantee name, award number) for each grant 
award in the universe of FY 2012 grant awards from each of these five 
awarding agencies. Because NIH awarded more than two-thirds of 
FY 2012 HHS grants, we selected a stratified random sample of 150 grant 
awards: 110 grant awards from  NIH and 40 grant awards from the 
remaining 4 awarding agencies.  The population and sample sizes are 
shown in Table 2.   
Table 2: Number of Grant Awards in Population and Sample  
by Stratum  
Awarding  Population 
Stratum   Sample Size  
Agency   Size 
1  NIH  50,445   110 
ACF  6,909  
CDC  3,867  
2  40 
HRSA  5,679  
SAMHSA  2,535 
   Total   69,435   150 
Source:  Tracking Accountability in Government Grants System report created on  
December 5, 2012. 
We surveyed grantee administrative staff (e.g., institutional grants officer) 
representing each grant award.  We asked about their awareness of the 
prohibitions on the use of grant funds for lobbying and the sources from  
which they derived this knowledge. We asked respondents to describe 
how their organizations ensured that grant funds were not used for 
prohibited lobbying. We also asked whether grantee organizations were 
contacted by awarding agencies regarding concerns about the potential use 
of grant funds for lobbying. Finally, we asked whether the respondents 
wanted further information about the lobbying prohibitions.  Overall, our 
survey had a 97-percent response rate.  Weighted response rates for 
individual survey questions ranged from 88 percent to 97 percent. 
Analysis  
We reviewed the departmental and awarding agency guidance and the 
standard language included in grant applications and notices of grant 
 
27  CMS awarded  about 74 percent  of HHS FY 2012 grant dollars, most  of which was  for  
Medicaid and  Childrens Health Insurance Program grants to States.   However, CMS 
awarded only  about 2 percent of  the number  of HHS FY 2012 grant awards; therefore, we 
did  not include CMS in  our population. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  9 
(OEI-07-12-00620)  
   
   
award to identify the guidance that awarding agencies used. We compared 
the guidance that awarding agencies reported being in effect in FY 2011 
with that in effect in FY 2012 to determine whether changes were made as 
a result of the enactment of section 503 of the FY 2012 HHS 
Appropriation. In addition, we reviewed language from FY 2012 grant 
applications and notices of award to see if it reflected the enactment of  
section 503.  We supplemented that analysis with the interview responses 
from CGMOs regarding how they informed grantees of the lobbying 
prohibitions.  We also used the interview responses to determine how 
awarding agencies monitored grantees for compliance with the 
prohibitions. 
We analyzed the responses to our survey of grantees to determine grantee 
awareness of the lobbying prohibitions and to assess grantees needs for 
additional information on this topic.  We also analyzed these survey 
responses to determine the methods that grantees used to ensure that grant 
funds were not used for prohibited lobbying. 
Scope 
The period of our review encompassed FYs 2011 and 2012.  We  
determined the extent to which grantees in five awarding agenciesACF, 
CDC, HRSA, NIH, and SAMHSAwere aware of lobbying prohibitions, 
but we did not make comparisons among awarding agencies or between 
NIH and the other four awarding agencies.  Grantee survey responses are 
self-reported; we did not verify their accuracy.  We did not examine 
expenditures to identify grantees that may have violated lobbying 
prohibitions. 
Standards 
This study was conducted in accordance with the Quality Standards for 
Inspection and Evaluation issued by the Council of the Inspectors General 
on Integrity and Efficiency. 
   
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  10 
(OEI-07-12-00620)  
   
   
FINDINGS 
All HHS awarding agencies reported using Federal and 
departmental guidance on the prohibitions on the use 
of grant funds for lobbying 
Each of the 13 awarding agencies we reviewed reported using 1 or more 
sources of Federal and/or departmental guidance on the topic of lobbying.  
Federal sources included 45 CFR pt. 93, OMB circulars, and annual 
appropriations acts. Departmental sources included the GPD, AAGAM, 
and GPS. Two awarding agencies published their own guidance with 
respect to lobbying prohibitions.  All but one awarding agency subject to 
the language in section 503 of the FY 2012 HHS Appropriation informed 
grantees that restrictions on lobbying with Federal funds appropriated 
under this specific Act had been broadened. 
Two awarding agencies supplemented Federal and 
departmental guidance with their own guidance 
Two awarding agencies (CDC and NIH) published guidance to grantees 
regarding the prohibitions on the use of grant funds for lobbying.  CDC 
published Additional Requirement 12, in effect in FY 2011 and updated in 
June 2012, which describes activities that do and do not constitute 
lobbying and addresses the prohibition on using CDC funds to engage in 
lobbying. For example, Additional Requirement 12 states that it is 
permissible for grantees to use CDC funds to conduct community outreach 
services, but cautions grantees to be careful not to give the appearance 
that CDC funds are being used to carry out activities in a manner that is 
prohibited under Federal law.  In July 2012, CDC distributed a six-page 
guidance document to grantees entitled Anti-Lobbying Restrictions for 
CDC Grantees. CDC intended this document to provide an overview of 
lobbying restrictions, along with examples of allowable and prohibited 
activities.  
On May 24, 2013, NIH published a reminder to grantees that all 
NIH-funded awards are subject to a prohibition on using Federal funds for 
lobbying. The reminder referenced the relevant NIHGPS chapter and 
section 503 of the FY 2012 HHS Appropriation. 
All but one awarding agency informed grantees of the 
language in the FY 2012 HHS Appropriation 
Most commonly, awarding agencies informed grantees of broadened 
lobbying restrictions in the FY 2012 HHS Appropriation by including the 
language from section 503 in the agencies terms and conditions of award.  
A few awarding agencies disseminated this information in additional 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  11 
(OEI-07-12-00620)  
   
   
ways. For example, NIH released a notice dated January 20, 2012, 
entitled Notice of Legislative Mandates in Effect for FY 2012, that 
provided information on the statutory provisions that limit the use of NIH 
grant funds. AHRQ sent an email to staff and published an article in its 
employee newsletter regarding Federal laws on lobbying prohibitions and 
section 503 of the FY 2012 HHS Appropriation. 
ACF grant officials reported that they  did not inform grantees specifically 
about section 503 of the FY 2012 HHS Appropriation.  However, the 
standard language in ACFs notices of award informs grantees that any 
applicable statutory or regulatory requirements directly apply to the award.   
IHS and FDA have separate appropriations acts; therefore, their grantees 
are not subject to the FY 2012 HHS Appropriation. 
Through grant applications, notices of award, and/or 
training, all HHS awarding agencies informed their 
respective grantees of the prohibitions on the use of 
grant funds for lobbying 
Most commonly, awarding agencies used the assurance and certification 
language in grant applications28 and terms and conditions in notices of 
award as information sources for grantees about the prohibitions on the 
use of grant funds for lobbying. For example, the Office of the Assistant 
Secretary for Health and ASPR included the language from section 503 of 
the FY 2012 HHS Appropriation in its entirety on notices of award.  Four 
awarding agencies included information on lobbying prohibitions in their  
funding-opportunity announcements or requests for applications. 
More than half of awarding agencies included lobbying 
information in grantee training  
Eight of the thirteen awarding agencies reported that lobbying is a topic 
covered during grantee training. For example, the Office of the National 
Coordinator for Health Information Technology reported that lobbying is 
addressed in grantee training entitled Staying Inside the Lines With 
Federal Funding.  For its Center for Tobacco Products grants, FDA  
approached each grantee individually  to provide training on this topic.  
Two awarding agenciesthe Office of the Assistant Secretary for Health 
and CMStold us that they had received specific inquiries from grantees 
regarding lobbying and that they had provided technical assistance in 
response. 
 
28 Grant applications include documents such as Public Health Service 398 and Standard 
Form 424. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  12 
(OEI-07-12-00620)    
   
For all sampled grant awards, grantees reported being 
aware of the prohibitions on the use of grant funds for 
lobbying; a few grantees suggested the need for more 
guidance 
For all grant awards in our sample, all grantees responded that they were 
aware of the lobbying prohibitions.29  For these awards, grantees reported 
various sources that informed them of the prohibitions and described 
methods by which their organizations ensured that Federal grant funds are 
not used for prohibited lobbying activities.  Only 3 percent of awards were 
associated with grantees that wanted to receive further information about 
the lobbying prohibitions. 
For grant awards, grantees reported becoming informed of the 
prohibitions through grant applications, awarding agency 
Web sites, and notices of award 
For 71 percent of grant awards, grantees reported receiving information 
about the prohibitions on the use grant funds for lobbying from grant 
applications or through reading funding-opportunity announcements.  
Additionally, 69 percent of awards were associated with grantees that 
reported receiving information about the prohibitions through agency 
Web sites, and 67 percent were associated with grantees that had received 
information by notices of award.  Other sources included Web sites 
(e.g., www.grants.gov, www.grantsolutions.gov), training and technical 
assistance (e.g., Web seminars, grantee orientation sessions), and awarding 
agency printed materials.  
For all the sampled grant awards, no grantees reported that they sought 
awarding agency clarification regarding the lobbying prohibitions, nor 
were they contacted by awarding agencies regarding concerns about 
potential prohibited lobbying activities. Furthermore, for all grant awards 
in our sample, no grantees reported that they had contacted awarding 
agencies with concerns about potential lobbying activities by either their 
own organizations or those of subgrantees.30  
 
29 Although  for all grant awards in  our sample, grantees reported awareness of the 
lobbying prohibitions and  we can  be confident that the percentage in the population is 
large and possibly 100 percent, we cannot  be certainbecause of sampling errorthat  
100 percent  of  the population was aware of the prohibitions.  We are at least 95  percent  
confident that the population percentage is greater than 94.5 percent. 
30 No  grant awards in  our sample were associated with grantees that sought clarification 
of guidance from awarding agencies, were contacted by awarding agencies, or contacted 
awarding agencies with concerns.  Although  we can be confident that the percentage in  
the population is  small  and possibly  none, we  cannot be certainbecause of  sampling 
errorthat  none of the awards in the population were  associated with such grantees.  We 
are at least 95  percent confident that the population  percentage is less than  5.5  percent. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  13 
(OEI-07-12-00620)    
   
For grant awards, grantees described two main methods used 
to ensure that grant funds are not used for prohibited lobbying 
activities  
First, for 66 percent of awards, grantees stated that they review 
expenditures or conduct internal audits to ensure that grant funds are not 
used for lobbying. For example, for one sampled award, the grantee 
explained that grantee officials review expenditures to determine whether 
they are allowable. In addition, the grantees accounting system contains 
certain edits that do not allow the accounting code for lobbying costs to be 
used against federally funded awards. 
Second, for 55 percent of awards, grantees pointed to internal policy 
communicated to grantee staff as a means to ensure that grant funds are 
not used for prohibited lobbying activities. For example, for one sampled 
award, the grantee stated that it has a policy requiring advance clearance 
prior to making appointments or establishing lobbying contacts with any 
local, State, or Federal elected officials.  In comparison, for 5 percent of 
awards, grantees responded that their organizations do not engage in any 
lobbying activities whatsoever, regardless of the funding source for those 
activities.  
Few awards were associated with grantees that indicated a 
desire for further guidance 
Three percent of awards were associated with grantees that wanted to 
receive further information about the prohibitions on the use of grant 
funds for lobbying. For two sampled awards, grantees suggested that Web 
site links to reference materials would be helpful and one grantee 
suggested a one-pager on the topic written in plain language without 
legal jargon.  The respondent stated that such a document would be useful 
to provide to subgrantees. Finally, for one sampled award, one grantee 
noted the continuing need for future updates as guidance changes in this 
area.  
Limited methods exist to identify noncompliance with 
prohibitions on lobbying; HHS awarding agencies 
found two instances of noncompliance in FYs 2011 
and 2012 
When signing grant applications, grantees certify that they are generally 
prohibited from using Federal funds for lobbying the executive or 
legislative branches of the Federal Government in connection with a 
specific grant. However, this is only a self-certification.  Awarding 
agencies have limited abilities to uncover potential noncompliance.  In 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  14 
(OEI-07-12-00620)    
   
FYs 2011 and 2012, awarding agencies identified two instances of 
prohibited lobbying activities. 
Awarding agencies described limited methods to identify 
lobbying activities prior to award and after award  
When we asked CGMOs about the ways in which lobbying activities are 
identified prior to award, they told us that there is limited information that 
would reveal such activities. One method that awarding agencies may use 
to identify potential lobbying activities is reviewing budgets.  For 
example, CMS grant officials told us that they look closely at planned 
expenditures for offsite meetings and follow up on areas about which they 
have questions. 
After a grant is awarded, there are more sources of information that could 
reveal a grantees prohibited lobbying activities.  CGMOs reported that, 
through reviewing expenditures, conducting site visits, or conducting 
conference calls, they could identify instances in which grant funds were 
used for lobbying. External sources of information are also important.  
Two awarding agencies mentioned that lobbying activities could be 
detected during an annual financial audit, and four awarding agencies 
mentioned whistleblowers or media reports.  One CGMO said that a 
whistleblower or media contact would be the primary source of identifying 
a possible violation. 
Awarding agencies identified two instances of noncompliance 
in FYs 2011 and 2012 
Two awarding agencies each identified one instance of noncompliance 
with the use of grant funds for lobbying activities during FYs 2011 and 
2012. In FY 2011, a CDC project officer identified one grantee that had 
conducted activities related to a planned press event regarding a local 
smoke-free ordinance.  In response, CDC sent the grantee a letter 
indicating that it was noncompliant with CDCs Additional 
Requirement 12, which addresses the lobbying prohibitions.  CDC 
disallowed all costs ($247.79) associated with the activities and required 
the grantee to repay or offset those costs with non-Federal funds.  In 
addition, CDC required the grantee and its contractors to attend training 
related to the antilobbying requirement. 
In FY 2012, HRSA officials initiated a review of one grantees 
expenditures following HRSA staff concerns that the grantee might have 
overcharged the grant for personnel and numerous new projects.  During 
their review of over $58 million of expenditures spanning 3 FYs, HRSA  
staff discovered expenditures for a July 2010 trip to Washington, D.C.  
The itinerary detailed the purchase of dinner and drinks for several 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  15 
(OEI-07-12-00620)    
   
legislative staff members, which raised concerns as to whether grant funds 
were used for lobbying. In May 2012, HRSA submitted a draft report to 
the grantee that identified these expenditures, as well as over $2 million in 
other unsupported and unallowable expenditures.  In response to followup 
documentation submitted by the grantee, HRSA issued a letter to the 
grantee in March 2013 requesting a refund of the unsupported and 
unallowable costs and allowing the grantee a final opportunity to submit 
additional documentation for the unsupported costs.  In May 2013, the 
grantee submitted additional documentation.  HRSA completed its review 
of the documentation in December 2013, continuing to disallow $5,258.94 
($3,005.11 in direct expenditures and $2,253.83 in indirect costs) because 
the expenditures (e.g., lodging, meals) were made for the purposes of 
lobbying. HRSA requested a refund of these costs.  The grantee filed an 
appeal of HRSAs decision.  As of May 2014, the appeal is pending with 
the Departmental Appeals Board.  
 
   
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  16 
(OEI-07-12-00620)    
   
CONCLUSION AND RECOMMENDATIONS 
Our results show that all awarding agencies reported using Federal and 
departmental sources of guidance regarding the prohibitions on the use of 
grant funds for lobbying. All awarding agencies informed their respective 
grantees of the prohibitions on the use of grant funds for lobbying through 
grant applications, notices of award, and/or training. 
Although the level of grantee awareness of lobbying prohibitions was high 
and identified noncompliance (i.e., the identified use of grant funds for 
prohibited lobbying activities) was low,  we note that limited methods exist 
for awarding agencies to identify prohibited lobbying activities.  Our data 
collection showed that awarding agencies look to ASFR to keep them  
informed of any changes to Federal and departmental guidance on this 
topic, such as the April 2012 Action Transmittal regarding the 
implementation of language in the FY 2012 HHS Appropriation.  
We recommend that ASFR: 
Facilitate Departmentwide information sharing about methods 
to identify uses of grant funds for prohibited lobbying  
activities  
Awarding agency CGMOs reported limited methods to identify the use of 
grant funds for prohibited lobbying activities, stating that third-party 
reports are a primary source of this information. Given the difficulty of 
identifying violations, whenever violations are identified ASFR should 
share this information with HHS awarding agencies.  ASFR could 
consider using its established Program Integrity Coordinating Council as 
the forum for information sharing.  
Centralize on its Web site the guidance pertaining to the 
prohibitions on the use of grant funds for lobbying 
On its Division of Grants Web site, ASFR highlights specific grants-policy 
topics (e.g., audits, objective grant review).  ASFR should add lobbying as 
one of these topics. This would serve as a central reference point for 
guidance at the Federal and department levels.  In addition, ASFR should 
include links to any evaluation reports regarding grantee lobbying.  ASFR 
should also include information about how individuals can report activities 
that might constitute federally prohibited lobbying activities. 
 
   
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  17 
(OEI-07-12-00620)    
   
AGENCY COMMENTS AND OFFICE OF INSPECTOR GENERAL  
RESPONSE 
ASFR concurred with both of the recommendations.  To address our first  
recommendation, ASFR stated that it will work with awarding agencies to  
determine the best use of resources to share information on methods to  
identify grant funds used for prohibited lobbying activities.  To address our 
second recommendation, ASFR stated that it will work with awarding 
agencies and the Office of the  Assistant Secretary for Public Affairs to 
ensure that the Division of Grants  Web site captures relevant lobbying 
guidance, links to any existing evaluation reports regarding grantee 
lobbying, and recommends a method of reporting activities that might 
constitute federally prohibited lobbying activities. 
For the full text of ASFRs comments, see Appendix B.    
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  18 
(OEI-07-12-00620)    
   
APPENDIX A 
Point Estimates and Confidence Intervals for Grantee Surveys 
We calculated confidence intervals for key data points for responses to our 
survey of grantees. The sample sizes, point estimates, and 95-percent 
confidence intervals are given for the each of the following: 
 
Sample  95-Percent 
Data Point Description   Point Estimate  
Size  Confidence Interval 
Awards associated with grantees 
responding that they  were aware of the 
146  100.0%   94.5%100.0%  
prohibitions on the use of Federal grant 
funds for lobbying   
Awards associated with grantees 
reporting that they  would like to receive 
145  2.8%   1.0%7.3%  
further information about lobbying  
prohibitions 
Awards associated with grantees 
reporting that they received information 
about lobbying prohibitions via grant  137  70.8%   62.6%77.9%  
applications or by reading 
funding-opportunity announcements 
Awards associated with grantees 
reporting that they received information 
132  69.5%   61.4%76.5%  
about lobbying prohibitions from 
awarding agency Web sites 
Awards associated with grantees 
reporting that they received information 
133  66.9%   58.3%74.4%  
about lobbying prohibitions from notices 
of award  
Awards associated with grantees 
reporting that they sought clarification 
from awarding agencies regarding the  146  0.0%   0.0%5.5%  
prohibitions on the use of grant funds 
for lobbying activities 
Awards associated with grantees 
reporting that awarding agencies 
contacted them regarding concerns  146  0.0%   0.0%5.5%  
about the potential use of grant funds 
for lobbying activities 
Awards associated with grantees 
reporting that they had contacted 
awarding agencies regarding concerns  146  0.0%   0.0%5.5%  
about the potential use of grant funds 
for lobbying activities 
Awards associated with grantees 
reporting that they review expenditures 
140  65.6%   57.3%73.0%  
or conduct internal audits to ensure that 
grant funds are not used for lobbying 
Awards associated with grantees 
reporting that internal policy is a means 
140  54.8%   46.6%62.8%  
of ensuring that grant funds are not 
used for prohibited lobbying activities 
Awards associated with grantees 
reporting that they do not engage in any  
140  5.1%   2.4%10.2%  
lobbying activities, regardless of the 
funding source for those activities 
Source:  OIG analysis of grantee surveys, 2013. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  19 
(OEI-07-12-00620)   APPENDIX B 
Agency Comments 
llLt';\J( I ~lloNT Ul' Ill AU II & HI. f'v1,.\ 'I SI'I<VH I.S 
MAY  2 2014 
TO:  Daniel R. Levinson 
Inspector General 
FROM:  Ellen G. Murray 
Assistant Secretary fltt' Finan~:ial Resources and Chief financial Onicer 
SUB.JECT: 	 HHS Comments on OIG Draft Report: Laws Prohibit the Uye o,(HJIS Grant 
FunJsfor J,obhying, hut Limited Methods Ex:isf to Identify Noncompliance, OEI
07-12-00620 
The Department of Health and Human St!rvices' (HHS's) Oftice of the Assistant Secretary for 
Financial Resources (ASfR) apprt!ciates the opportunity to review and comment on the Office of 
Inspector General's drafl. report: Laws J'rohibit the Use of1!l!S Granr Funds for Lobbying, but 
Limited lv!ethods E-...:is/10 Jdent(fY Noncompliance. OEI-07-12-00620. 
ASFR values Jcpartmentwide inlormation sharing and is committed to ensuring that guidance to 
HHS's awarding agencies related to the prohibition and identification of the use of HHS grant 
funds for lobbying activities is eiTectively disseminated and incorporated into grants 
administration practices.  As the report states, all HHS awarding agencies usc federal and 
departmental sources of guidance regarding the prohibition on the use of grant i.mds for 
lobbying, and employ numerous methods to inform grantees through grant applications. notices 
ofaward, and/or training. 
ASFR concurs with the OIG that additional information sharing between ASFR and the 
awarding agencies regarding methods to identify uses of grant funds for prohibited lobbying 
activities is appropriate and warranted. ASfR \Viii work with the awarding agencies to 
determine the most efl'ective and efficient use ofresources to accomplish this coordination and 
information sharing.  We will provide the OTG with an update on these efforts as they progress. 
ASFR also agrees that it should centralize federal and depaitmental guidance pertaining to the 
prohibitions on the use of grants funds for lobbying on its Division ofGrants website.  ASFR 
will work with the awarding agencies and the Office of the Assistant Secretary for Public Af'Cairs 
to ensure the site captures relevant lobbying guidance, links to any existing evaluation reports 
regarding gnmtee lobbying activities, and a recommended method of reporting potential 
violations offederal laws on prohibited lobbying activities.  We will provide the OTG with an 
update on these cff(ll1s as they progress. 
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  20 
(OEI-07 -12-00620)   
   
ACKNOWLEDGMENTS 
This report was prepared under the direction of Brian T.  Whitley, Regional 
Inspector General in the Kansas City regional office.  
Tricia Fields served as the team leader for this study.  Other Office of 
Evaluation and Inspections staff from the Kansas City regional office who 
conducted the study include Dennis Tharp.  Central office staff who 
provided support include Heather Barton, Althea Hosein, Christine Moritz, 
and Talisha Searcy.  
Laws Prohibit the Use of HHS Grant Funds for Lobbying, but Limited Methods Exist To Identify Noncompliance  21 
(OEI-07-12-00620)    
Office of Inspector General
http://oig.hhs.gov  
 
The mission of the Office of Inspector General (OIG), as mandated by Public Law 95-452, as  
amended, is  to protect the integrity of the Department of  Health and Human Services  
(HHS)  programs, as well as the health and welfare of beneficiaries  served by those 
programs.  This statutory mission  is  carried  out through  a nationwide network  of  audits, 
investigations, and inspections conducted by the  following operating components: 
Office of Audit Services 
The Office  of  Audit Services  (OAS) provides auditing services  for HHS, either by  conducting  
audits  with its own audit resources or by  overseeing  audit work done by others.  Audits  
examine the performance of HHS programs and/or its grantees and contractors in carrying  
out their respective responsibilities and are intended  to provide independent assessments of 
HHS programs and operations.  These assessments help reduce waste, abuse, and  
mismanagement and promote economy and efficiency  throughout  HHS. 
Office of Evaluation and Inspections 
The Office  of  Evaluation and Inspections (OEI)  conducts national evaluations to  provide 
HHS, Congress, and the public with timely, useful, and reliable information on significant 
issues.  These evaluations focus on preventing fraud,  waste, or abuse  and promoting  
economy, efficiency, and effectiveness of departmental programs.  To promote impact, OEI 
reports also present practical recommendations for improving program operations.  
Office of Investigations 
The Office of Investigations (OI) conducts criminal, civil, and administrative investigations  
of  fraud and misconduct  related to HHS programs, operations, and beneficiaries.  With 
investigators working in all 50 States and the District of Columbia, OI  utilizes its resources 
by actively  coordinating with the Department  of Justice  and other Federal, State, and local 
law enforcement authorities.  The investigative efforts of OI often lead to  criminal 
convictions, administrative sanctions,  and/or  civil monetary  penalties.  
Office of Counsel to the Inspector General 
The Office of Counsel to the  Inspector  General (OCIG) provides general legal services to 
OIG, rendering  advice and opinions on HHS programs and operations and  providing all  
legal support for OIGs  internal operations.  OCIG represents  OIG in all civil and 
administrative fraud and abuse cases involving HHS programs,  including False Claims Act, 
program exclusion, and civil monetary penalty cases.  In  connection with these cases, OCIG 
also negotiates and monitors corporate integrity agreements.  OCIG renders advisory 
opinions, issues compliance program  guidance, publishes fraud alerts, and provides other  
guidance  to  the health care industry concerning the anti-kickback statute and other  OIG  
enforcement authorities.