In planning and performing our audit of the BOP's Efforts to Manage Inmate Health Care, we considered the BOP's internal controls for the purpose of determining our auditing procedures. The evaluation was not made for the purpose of providing assurance on the internal control structure as a whole; however, as shown below, we noted certain matters that we consider reportable conditions under generally accepted government auditing standards.27
The BOP did not maintain documentation of any preliminary cost-benefit analyses or post-implementation analyses to identify costs reduced or contained for its health care initiatives.
The BOP’s institutions did not always provide recommended preventative medical services to inmates.
The BOP institutions had not established controls to ensure that contract administration deficiencies found during OIG audits of medical contracts at other BOP institutions were corrected.
The BOP had not addressed agency-wide the systemic deficiencies found during OIG audits of BOP medical contracts.
The BOP had not addressed agency-wide the systemic deficiencies found during the Program Review Division’s program reviews at BOP institutions.
The BOP had not established effective controls to ensure that BOP health care providers were provided privileges, practice agreements, or protocols as required by BOP policy.
The BOP had not established effective controls to ensure that BOP health care providers received an internal peer review as required by BOP policy.
The BOP had not established an effective system for monitoring institution progress against performance measures and taking actions when performance was below target levels.
Because we are not expressing an opinion on the BOP's overall internal control structure, this statement is intended solely for the information and use of the BOP in managing inmate health care.