[Federal Register Volume 61, Number 93 (Monday, May 13, 1996)]
[Notices]
[Pages 22059-22064]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 96-11844]



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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Office of the Secretary


Office of Inspector General; Statement of Organization, Functions 
and Delegations of Authority

    This Notice amends Part A (Office of the Secretary) of the 
Statement of Organization, Functions and Delegations of Authority for 
the Department of Health and Human Services (HHS) to reflect recent 
changes in Chapter AF, Office of Inspector General (OIG). Chapter AF 
was last published in its entirety on November 7, 1989 (54 FR 46775).
    The statement of organization, functions and delegations of 
authority reflects the original transfer of the statutory basis for the 
Office of Inspector General from Public Law 94-505 to Public Law 95-452 
(and made under the Inspector General Act Amendments of 1988, Public 
Law 100-504), and conforms to and carries out the statutory 
requirements for operating the Office of Inspector General. A number of 
revisions have been made to the basic organizational structure of the 
Office of Inspector General to reflect the break out of functions from 
the Office of Civil Fraud and Administrative Adjudication (OCFAA) into 
two separate organizational units, and the effect of recent shifts and 
changes, such as the separation out of the Social Security 
Administration in accordance with the Social Security Independence and 
Program Improvements Act of 1994 (Public Law 103-296). As a result, 
within the organizational structure of the OIG: (1) A new Office of 
Enforcement and Compliance (OEC) and a new Office of Litigation 
Coordination (OLC) have been formed, (2) certain units and positions 
have recently been renamed, (3) minor shifts in reporting relationships 
have occurred, (4) an additional program unit has been delineated, and 
(5) some small functional units have been transferred. While relatively 
minor, these changes have been made in an effort to assist the 
organization in accomplishing its mission with greater efficiency and 
effectiveness.
    As amended, Chapter AF now reads as follows:

Section AF.00, Office of Inspector General (OIG)--Mission

    This organization was established by law as an independent and 
objective oversight unit of the Department to carry out the mission of 
promoting economy, efficiency and effectiveness

[[Page 22060]]

through the elimination of waste, abuse and fraud. In furtherance of 
this mission, the organization engages in a number of activities:
    A. Conducting and supervising audits, investigations, inspections 
and evaluations relating to HHS programs and operations.
    B. Identifying systemic weaknesses giving rise to opportunities for 
fraud and abuse in HHS programs and operations and making 
recommendations to prevent their recurrence.
    C. Leading and coordinating activities to prevent and detect fraud 
and abuse in HHS programs and operations.
    D. Detecting wrongdoers and abusers of HHS programs and 
beneficiaries so appropriate remedies may be brought to bear.
    E. Keeping the Secretary and the Congress fully and currently 
informed about problems and deficiencies in the administration of such 
programs and operations and about the need for and progress of 
corrective action, including imposing sanctions against providers of 
health care under Medicare and Medicaid who commit certain prohibited 
acts.
    In support of its mission, the Office of Inspector General carries 
out and maintains an internal quality assurance system and a peer 
review system with other Offices of Inspectors General, that include 
periodic quality assessment studies and quality control reviews, to 
provide reasonable assurance that applicable laws, regulations, 
policies, procedures, standards and other requirements are followed; 
are effective; and are functioning as intended in OIG operations.

Section AF.10, Office of Inspector General--Organization

    There is at the head of the OIG a statutory Inspector General, 
appointed by the President and confirmed by the Senate. The Office of 
Inspector General consists of seven organizational units:
    A. Immediate Office of the Inspector General (AFA).
    B. Office of Management and Policy (AFC).
    C. Office of Evaluation and Inspections (AFE).
    D. Office of Enforcement and Compliance (AFF).
    E. Office of Litigation Compliance (AFG).
    F. Office of Audit Services (AFH).
    G. Office of Investigations (AFJ).

Section AF.20, Office of Inspector General--Functions

    The component sections which follow describe the specific functions 
of the organization.

Section AFA.00, Immediate Office of the Inspector General (IOIG)--
Mission

    The Inspector General is directly responsible for meeting the 
statutory mission of the OIG as a whole and for promoting effective OIG 
internal quality assurance systems, including quality assessment 
studies and quality control reviews of OIG processes and products. The 
Office of Inspector General also plans, conducts and participates in a 
variety of inter-agency cooperative projects and undertakings relating 
to fraud and abuse activities with the Department of Justice (DoJ), the 
Health Care Financing Adminstration (HCFA) and other governmental 
agencies.

Section AFA.10, Immediate Office of the Inspector General--
Organization

    The Immediate Office comprises the Inspector General, the Principal 
Deputy Inspector General, and an immediate staff.

Section AFA.20, Immediate Office of the Inspector General--
Functions

    As the senior official of the organization, the Inspector General 
supervises the Deputy Inspectors General and the Assistant Inspector 
General for Litigation Coordination who head the major OIG components. 
The Inspector General is appointed by the President, with the advice 
and consent of the Senate, and reports to and is under the general 
supervision of the Secretary or, to the extent such authority is 
delegated, the Deputy Secretary, but does not report to and is not 
subject to supervision by any other officer in the Department. In 
keeping with the independence intended in the statutory basis for the 
OIG and its mission, the Inspector General assumes and exercises, 
through line management, all functional authorities related to the 
administration and management of the OIG and all mission related 
authorities stated or implied in the law or delegated directly from the 
Secretary.
    The Inspector General provides executive leadership to the 
organization and exercises general supervision over the personnel and 
functions of its major components. The Inspector General determines the 
budget needs of the OIG, sets OIG policies and priorities, oversees OIG 
operations and provides reports to the Secretary and the Congress. In 
this capacity the Inspector General is empowered under the law with 
general personnel authority, e.g., selection, promotion, assignment of 
employees, including members of the senior executive service. The 
Inspector General delegates related authorities as appropriate.
    The Principal Deputy Inspector General assists the Inspector 
General in the management of the OIG, and during the absence of the 
Inspector General, acts as the Inspector General.

Section AFC.00, Office of Management and Policy (OMP)--Mission

    This office is responsible for the reporting and legislative and 
regulatory review functions required in the law; for formulating and 
executing the OIG budget; for managing external affairs; and for 
establishing functional policies for the general management of the OIG. 
In support of its mission, the office carries out and maintains an 
internal quality assurance system. The system includes quality 
assessment studies and quality control reviews of OMP processes and 
products to ensure that policies and procedures are followed 
effectively and function as intended.

Section AFC.10, Office of Management and Policy--Organization

    This office is directed by the Deputy Inspector General for 
Management and Policy, and comprises the Deputy Inspector General for 
OMP and an immediate staff.

Section AFC.20, Office of Management and Policy--Functions

    Through the Deputy Inspector General for Management and Policy:
    A. The office conducts and coordinates OIG reviews of existing and 
proposed legislation and regulations related to HHS programs and 
operations to identify their impact on economy and efficiency and their 
potential for fraud and abuse. It develops all OIG sanction and 
interpretive regulations for publication in the Federal Register and 
legislative proposals for inclusion in the Department's legislative 
program. It serves as contact for the press and electronic media and 
serves as OIG congressional liaison. The office prepares congressional 
testimony and confers with officials in the Office of the Secretary 
staff divisions on congressional relations, legislation and public 
affairs. It develops and publishes OIG newsletters, recruitment 
brochures and other issuances to announce and promote OIG activities 
and accomplishments.
    B. The office coordinates the development of the OIG long-range 
strategic plan. It compiles the Semiannual Report to the Congress and 
operates the Executive Secretariat. It formulates and oversees the 
execution of the OIG budget and confers with the Office of the 
Secretary, the Office of

[[Page 22061]]

Management and Budget and the Congress on budget issues. It issues 
quarterly grants to States for Medicaid fraud control units. It 
conducts management studies and analyses and establishes and 
coordinates general management policies for the OIG and publishes those 
policies in the OIG Administrative Manual. It serves as OIG liaison to 
the Office of the Secretary for personnel issues and other 
administrative policies and practices, and on equal employment 
opportunity and other civil rights matters. It coordinates internal 
control reviews for the OIG.
    C. The office is responsible for OIG information resources 
management (IRM), as defined by the Paperwork Reduction Act, OMB 
Circular A-130, the Federal Information Resources Management 
regulations, the Computer Security Act of 1987, HHS IRM Circulars, and 
by related guidance. The office also provides information technology 
support to the OIG through management of its local area networks 
nationwide, provision of headquarters computer end-user support, and 
support of OIG information systems as required.

Section AFE.00, Office of Evaluation and Inspections (OEI)--Mission

    The Office of Evaluation and Inspections is responsible for 
conducting inspections of HHS programs, operations and processes to 
identify vulnerabilities, to prevent and detect misconduct, and to 
promote economy, efficiency and effectiveness in HHS programs and 
operations. In support of its mission, the office carries out and 
maintains an internal quality assurance system. The system includes 
quality assessment studies and quality control reviews of OEI processes 
and products to ensure that policies and procedures are effective; are 
followed; and are functioning as intended.

Section AFE.10, Office of Evaluation and Inspections--Organization

    This office is directed by the Deputy Inspector General for 
Evaluation and Inspections, and comprises the Immediate Office, 
including the Deputy Inspector General for OEI and an immediate staff, 
and eight regional offices.

Section AFE.20, Office of Evaluation and Inspections--Functions

    The office is responsible for carrying out inspections supporting 
the OIG mission. The Deputy Inspector General provides general 
supervision to the OEI immediate office staff and supervises the 
Regional Inspectors General for Evaluation and Inspections who carry 
out OEI's mission and activities in assigned geographic areas. The 
Immediate Office carries out OEI's mission in headquarters.
    A. The immediate office develops OEI's evaluation and inspections 
policies, procedures and standards. It assesses the quality of 
inspections to ensure compliance with policies and procedures. It 
manages OEI's human and financial resources. It develops and monitors 
OEI's management information systems. It conducts management reviews 
within the HHS/OIG and for other OIG's upon request.
    B. The immediate office manages OEI's work planning process and 
reviews legislative, regulatory and program proposals for 
vulnerabilities to fraud, waste and mismanagement. It develops 
evaluation techniques and coordinates projects with other OIG and 
departmental components. It provides programmatic expertise and 
information on new programs, procedures, regulations and statutes to 
OEI regional offices. It maintains liaison with other components in the 
Department, follows up on implementation of corrective action 
recommendations, evaluates the actions taken to resolve problems and 
vulnerabilities identified, and provides additional data or corrective 
action options, where appropriate.
    C. The regional offices carry out OEI's mission in the field. The 
regional offices evaluate HHS programs and produce the results in 
inspection reports. They conduct data and trend analyses of major HHS 
initiatives to determine the effects of current policies and practices 
on program efficiency and effectiveness. They recommend changes in 
program policies, regulations and laws to improve efficiency and 
effectiveness, and to prevent fraud, abuse, waste and mismanagement. 
They analyze existing policies to evaluate options for future policy, 
regulatory and legislative improvements.

Section AFF.00, Office of Enforcement and Compliance (OEC)--Mission

    The Office of Enforcement and Compliance is responsible for the 
imposition of those mandatory and permissive program exclusions and 
civil money penalty (CMP) and assessment actions not handled by the 
Office of Litigation Coordination. The office serves as a liaison with 
HCFA, State licensing boards and other outside organizations and 
entities with regard to integrity, compliance and enforcement 
activities. It develops models for corporate integrity, compliance and 
enforcement programs; monitors ongoing compliance, exclusion and HCFA 
suspension agreements; and promotes industry awareness of corporate 
integrity and enforcement agreements developed by the OIG.

Section AFF.10, Office of Enforcement and Compliance--Organization

    This office is directed by the Deputy Inspector General for 
Enforcement and Compliance, and comprises the Deputy Inspector General 
for OEC and an immediate staff.

Section AFF.20, Office of Enforcement and Compliance--Functions

    Through the Deputy Inspector General for Enforcement and 
Compliance:
    A. The office develops, coordinates and effectuates all health care 
mandatory and permissive exclusions, with the exception of those 
handled by the Office of Litigation Coordination. The office develops 
standards governing the imposition of the mandatory and permissive 
exclusion authorities within the scope of its responsibility, and 
develops criteria for evaluating when it will impose such permissive 
exclusions against health care providers. It reviews all applications 
for readmission to program participation for purposes of determining 
whether an excluded provider has demonstrated the ability to comply 
with program requirements; and ensures enforcement of exclusions 
imposed through liaison with HCFA, DoJ and other governmental and 
private sector entities.
    B. The office is responsible for developing, improving and 
maintaining a comprehensive and coordinated OIG data base on all OIG 
exclusion actions, and promptly and accurately reports all exclusion 
actions within its authority to the data base. It informs appropriate 
regulatory agencies, health care providers and the general public of 
all OIG exclusion actions, and is responsible for improving public 
access to information on these exclusion actions to ensure that 
excluded individuals and entities are effectively barred from program 
participation.
    C. The office imposes CMPs and assessments in accordance with the 
CMP law on those cases not handled by the Office of Litigation 
Coordination, and ensures that all monetary recoveries are promptly and 
accurately reported to the appropriate OIG data base.
    D. The office monitors corporate and provider compliance plans 
adopted as part of settlement agreements, and develops audit and 
investigative review standards for monitoring such plans in cooperation 
and coordination with other OIG components. It resolves breaches of 
compliance plans through the development of corrective action plans, 
on-site reviews, and when appropriate,

[[Page 22062]]

refers material breaches of compliance plans to the Office of 
Litigation Coordination for potential sanctioning.
    E. The office serves to increase industry awareness of corporate 
integrity issues by proactively promoting voluntary adoption of 
corporate compliance plans through speeches, articles, visits and other 
liaison activities with governmental and private sector groups.

Section AFG.00, Office of Litigation Coordination (OLC)--Mission

    The Office of Litigation Coordination is responsible for the 
coordination and disposition of all qui tam and other False Claims Act 
matters, and other criminal, civil and administrative matters when DoJ 
has an interest in the matter; the coordination and disposition of all 
voluntary disclosure activities; liaison activities with HCFA and 
outside entities in global settlement negotiations; the development of 
standards governing use of permissive exclusion authority in cases 
involving DoJ, including and United States Attorney's Office; and the 
establishment and maintenance of a data system on settled and pending 
False Claim Act and CMP cases.

Section AFG.10, Office of Litigation Coordination--Organization

    The office is directed by the Assistant Inspector General for 
Litigation Coordination, and comprises the Assistant Inspector General 
of OLC and an immediate staff.

Section AFG.20, Office of Litigation Coordination--Mission

    Through the Assistant Inspector General for Litigation 
Coordination:
    A. The office oversees all False Claims Act and qui tam cases, 
including the handling of (1) requests for extensions of intervention 
dates, (2) resource requests from other agencies, (3) resource 
coordination among the OIG components, (4) settlement negotiations and 
(5) final sign-off. By coordinating DoJ resource requests, 
participating in settlement negotiations and providing litigation 
support, the office serves as the primary focal point for most criminal 
and civil cases involving other government agencies or more than one 
OIG component. It coordinates the Department's response to all 
settlement proposals in cases involving DoJ, including the amount of 
restitution and resolution of the selected CMP and exclusion liability, 
and serves as the liaison to other components of the Department in 
these cases.
    B. The office coordinates and resolves all voluntary disclosures 
through (1) liaison activities with DoJ and the U.S. Attorney's office, 
(2) the disclosure verification efforts of the Office of Audit Services 
and the Office of Investigations and (3) final disposition and sign-off 
of the matter.
    C. The office, in coordination with other OIG components, develops 
both the standards governing the use of permissive exclusion 
authorities in cases involving other Federal agencies, including DoJ, 
and the criteria for evaluating whether to impose permissive exclusions 
against health care providers in such cases. It is responsible for 
ensuring that all exclusion actions not handled by the Office of 
Enforcement and Compliance are promptly and accurately reported to the 
appropriate OIG data base.
    D. The office is responsible for developing, improving and 
maintaining a comprehensive and coordinated data base on all settled 
and pending False Claims Act and CMP cases under its authority. The 
office, through this data base, records all monetary recoveries and 
tracks outstanding qui tam, OIG intercomponent and multiple agency 
health care fraud investigations.

Section AFH.00, Office of Audit Services (OAS)--Mission

    The Office of Audit Services provides policy direction for and 
conducts and oversees comprehensive audits of HHS programs, operations, 
grantees and contractors, following generally accepted Government 
auditing standards (GAGAS), the Single Audit Act of 1984, applicable 
Office of Management and Budget (OMB) circulars and other legal, 
regulatory and administrative requirements. It maintains an internal 
quality assurance system, including periodic quality assessment studies 
and quality control reviews, to provide reasonable assurance that 
applicable laws, regulations, policies, procedures, standards and other 
requirements are followed in all audit activities performed by, or on 
behalf of, the Department. In furtherance of this mission, the 
organization engages in a number of activities:
    A. The office coordinates and confers with officials of the central 
Federal management agencies (OMB, the General Accounting Office (GAO), 
the Office of Personnel Management (OPM) and the Department of the 
Treasury) on audit matters involving HHS programs and operations. It 
provides technical assistance to Federal, State and local investigative 
offices on matters concerning the operation of the Department's 
programs. It participates in interagency efforts implementing OMB 
Circulars A-128 and A-110, which call for use of the single audit 
concept for most external audits. It performs audits of activities 
administered by other Federal departments, following the system of 
audit cognizance administered by OMB. It participates in the 
President's Council on Integrity and Efficiency (PCIE) initiatives and 
other Government-wide projects. It works with other OIG components on 
special assignments and projects. It responds to congressional 
oversight interests related to audit matters in the Department.
    B. The Office of Audit Services helps HHS operating divisions and 
the Office of the Secretary staff divisions to develop policies to 
manage grants and procurements and policies to establish indirect cost 
rates. It performs pre-award audits of grant or contract proposals to 
determine the financial capability of the grantees or contractors and 
conducts post-award audits.
    C. The office reviews legislative, regulatory and policy proposals 
for audit implications. It recommends improvements in the 
accountability and integrity features of legislation, regulations and 
policy. It prepares reports of audits and special studies for the 
Secretary, heads of HHS operating divisions, Regional Directors and 
others. It gathers data on unresolved audit findings for the 
statutorily required Semiannual Reports to the Congress and for the 
Deputy Secretary as Chairman of the Audit Resolution Council. It 
conducts follow-up examinations and special analyses of actions taken 
on previously reported audit findings and recommendations to ensure 
completeness and propriety.
    D. The office decides when audits can or may be performed by audit 
organizations outside the Department, including those by other Federal 
or nonfederal governmental agencies, contractors, or public accounting 
firms. It assures that any audit performed by non-OIG auditors complies 
with the Government auditing standards established by the Comptroller 
General of the United States. It evaluates audits performed for the 
Department by outside organizations. It coordinates the development of 
the OIG Annual Work Plan and produces summaries of both (1) the Orange 
Book--a summary of unimplemented program and management improvements 
recommended--and (2) the Red Book - a summary of significant monetary 
recommendations not yet implemented.
    E. The office serves as the focal point for all financial audit 
activity within the Department and provides the primary liaison conduit 
between the OIG and

[[Page 22063]]

departmental management. The office provides overall leadership and 
direction in carrying out the responsibilities mandated under the Chief 
Financial Officers Act relating to financial statement audits.

Section AFH.10, Office of Audit Services--Organization

    The Office of Audit Services comprises the following components:
    A. Immediate Office
    B. Audit Operations and Financial Statement Activities.
    C. Health Care Financing Audits.
    D. Administrations of Children, Family and Aging Audits.
    E. Public Health Audits.

Section AFH.20, Office of Audit Services--Functions

    A. Immediate Office of the Deputy Inspector General for Audit 
Services. This office is directed by the Deputy Inspector General for 
Audit Services who carries out the functions designated in the law for 
the position, Assistant Inspector General for Auditing. The Deputy 
Inspector General for Audit Services is responsible to the Inspector 
General for carrying out OIG's audit mission and supervises the 
Assistant Inspectors General heading OAS offices described below.
    The Immediate Office manages the human and financial resources of 
the Office of Audit Services including developing staffing allocation 
plans and issuing policy for, coordinating and monitoring all budget, 
staffing, recruiting and training activities of the office. It 
maintains a professional development program for Office of Audit 
Services staff which meets the requirements of Government auditing 
standards. The office provides liaison with the General Accounting 
Office. It reviews all replies to GAO reports to ensure they are 
responsive, properly coordinated and representative of HHS policy and 
advises the Secretary and other officials about significant findings.
    B. Audit Operations and Financial Statement Activities. This office 
is directed by the Assistant Inspector General for Audit Operations and 
Financial Statement Activities. In addition to directing this office, 
the Assistant Inspector General supervises the eight Regional 
Inspectors General for Audit Services. The office's principal functions 
include providing direction and oversight to OAS through its work 
planning and quality assurance activities; the direct-line 
responsibility for audits of financial statements and financial related 
audits, including internal audits of functional areas within the 
Department; and directing field audit operations.
    1. The office serves as the focal point for all financial statement 
and financial related audit activity within the Department and serves 
as the primary liaison conduit between the OIG and departmental 
management.
    2. The office operates an internal quality assurance system that 
provides reasonable assurance that applicable laws, regulations, 
policies, procedures, standards and other requirements are followed in 
all audit activities performed by, or on behalf of, the Department.
    3. The office evaluates audit work, including performing quality 
control reviews of audit reports, and develops and monitors audit work 
plans. It develops audit policy, procedures, standards, criteria and 
instructions for all audit activities performed by, on behalf of, or 
conforming with departmental programs, grants, contracts or operations 
in accordance with GAGAS and other legal, regulatory and administrative 
requirements.
    4. The office tracks, monitors and reports on audit resolution and 
follow-up in accordance with OMB Circular A-50.
    5. The office provides oversight for audits of governments, 
universities and nonprofit organizations conducted by nonfederal 
auditors and those under contract with the OIG (external audit 
resources).
    6. The office coordinates with the other OIG components in 
developing the semiannual report to Congress.
    C. Health Care Financing Audits. This office is directed by the 
Assistant Inspector General for Health Care Financing Audits. The 
office conducts audits of HCFA program operations and oversees 
nationwide the audits of the Medicare and Medicaid programs, their 
contractors, and providers of services and products. It maintains an 
internal quality assurance system, including periodic quality control 
reviews, to provide reasonable assurance that applicable laws, 
regulations, policies, procedures, standards and other requirements are 
followed in all HCFA audit activities performed by, or on behalf of, 
the Department.
    D. Administrations of Children, Family and Aging Audits. This 
office is directed by the Assistant Inspector General for 
Administrations of Children, Family and Aging Audits. The office 
conducts and oversees audits of the operations and programs of the 
Administration for Children and Families and the Administration on 
Aging, as well as statewide cost allocation plans. It maintains an 
internal quality assurance system, including periodic quality control 
reviews, to provide reasonable assurance that applicable laws, 
regulations, policies, procedures, standards and other requirements are 
followed in its audit activities.
    E. Public Health Audits. This office is directed by the Assistant 
Inspector General for Public Health Audits. The office conducts and 
oversees audits of the programs and activities of the public health 
related agencies, including the Food and Drug Administration; the 
National Institutes of Health; the Health Resources and Services 
Administration; the Alcohol, Drug Abuse, and Mental Health 
Administration; the Centers for Disease Control and Prevention; the 
Agency for Toxic Substances and Disease Registry; the Indian Health 
Service and the Surgeon General, as well as those colleges, 
universities and nonprofit organizations that receive research grants 
from the Federal Government. It maintains an internal quality assurance 
system, including periodic quality control reviews, to provide 
reasonable assurance that applicable laws, regulations, policies, 
procedures, standards and other requirements are followed in all public 
health related audit activities performed by, or on behalf of, the 
Department.

Section AFJ.00, Office of Investigations (OI)--Mission

    The Office of Investigations is responsible for conducting and 
coordinating investigative activities related to fraud, waste, abuse 
and mismanagement in HHS programs and operations, including wrongdoing 
by applicants, grantees, or contractors, or by HHS employees in the 
performance of their official duties. It serves as OIG liaison to DoJ 
on all matters relating to investigations of HHS programs and 
personnel, and reports to the Attorney General when the OIG has 
reasonable grounds to believe Federal criminal law has been violated. 
It works with other investigative agencies and organizations on special 
projects and assignments. In support of its mission, the office carries 
out and maintains an internal quality assurance system. The system 
includes quality assessment studies and quality control reviews of OI 
processes and products to ensure that policies and procedures are 
followed effectively, and are functioning as intended.

Section AFJ.10, Office of Investigations--Organization

    The Office of Investigations comprises the following components:
    A. Immediate Office.
    B. Criminal Investigations.

[[Page 22064]]

    C. Investigations Policy and Oversight.

Section AFJ.20, Office of Investigations--Functions

    A. Immediate Office of the Deputy Inspector General for 
Investigations. This office is directed by the Deputy Inspector General 
for Investigations who is responsible for the functions designated in 
the law for the position, Assistant Inspector General for 
Investigations. The Deputy Inspector General for Investigations 
supervises the Assistant Inspectors General who head the OI offices 
described below.
    The Deputy Inspector General for Investigations is responsible to 
the Inspector General for carrying out the investigative mission of the 
OIG and for leading and providing general supervision to the OIG 
investigative component. The Immediate Office coordinates quality 
assurance studies to ensure that applicable laws, regulations, 
policies, procedures, standards and other requirements are followed in 
all investigative activities performed by, or on behalf of, the 
Department.
    B. Criminal Investigations. This office is directed by the 
Assistant Inspector General for Criminal Investigations who supervises 
a headquarters policy and review staff and the Regional Inspectors 
General for Investigations who carry out investigative activities in 
their assigned geographic areas.
    1. The headquarters staff assists the Deputy Inspector General for 
Investigations to establish investigative priorities, to evaluate the 
progress of investigations, and to report to the Inspector General on 
the effectiveness of investigative efforts. It develops and implements 
investigative techniques, programs, guidelines and policies. It 
provides programmatic expertise and issues information on new programs, 
procedures, regulations and statutes. It directs and coordinates the 
investigative field offices.
    2. The headquarters staff reviews completed reports of 
investigations to ensure accuracy and compliance with guidelines. It 
issues the reports to pertinent agencies, management officials and the 
Secretary and recommends appropriate debarment actions, administrative 
sanctions, CMPs and other civil actions, or prosecution under criminal 
law. It identifies systemic and programmatic vulnerabilities in the 
Department's operations and makes recommendations for change to the 
appropriate managers.
    3. The staff provides for the personal protection of the Secretary.
    4. The field offices conduct investigations of allegations of 
fraud, waste, abuse, mismanagement and violations of standards of 
conduct and other investigative matters within the jurisdiction of the 
OIG. They coordinate investigations and confer with HHS operating 
divisions, staff divisions, OIG counterparts and other investigative 
and law enforcement agencies. They prepare investigative and management 
improvement reports.
    C. Investigations Policy and Oversight. This office is directed by 
the Assistant Inspector General for Investigations Policy and Oversight 
who leads outreach activities to State and local investigative 
agencies, and the general management functions of the Office of 
Investigations.
    1. The office oversees State Medicaid fraud control units and is 
responsible for certifying and recertifying these units and for 
auditing their Federal funding. The office provides pertinent 
information from HHS records to assist Federal, State and local 
investigative agencies to detect, investigate and prosecute fraud. It 
manages the HHS Hotline to receive complaints and allegations of fraud, 
waste and abuse, and to refer the information for investigation, audit, 
program review, or other appropriate action. It coordinates with the 
GAO hotline and hotlines from other agencies.
    2. The office maintains an automated data and management 
information system used by all OI managers and investigators. It 
provides technical expertise on computer applications for 
investigations and coordinates and approves investigative computer 
matches with other agencies.
    3. The office develops general management policy for the OI. It 
develops and issues instructional media on detecting wrongdoing and on 
investigating and processing cases. The office reviews proposed 
legislation, regulations, policies and procedures to identify 
vulnerabilities and recommends modification where appropriate. It 
reviews investigative files in response to Privacy and Freedom of 
Information Act requests. It plans, develops, implements and evaluates 
all levels of employee training for investigations, management, support 
skills and other functions, and serves as OIG liaison to the Office of 
the Secretary for Freedom of Information and Privacy Act requests. It 
coordinates general management processes, e.g., compiles reports on the 
budget, on awards and on other personnel matters for OI as a whole; 
implements policies and procedures published in the OIG Administrative 
Manual; and processes procurement requests and other service related 
actions.

    Dated: April 25, 1996.
June Gibbs Brown,
Inspector General.
[FR Doc. 96-11844 Filed 5-10-96; 8:45 am]
BILLING CODE 4150-04-P