Finding 530051 (2024-057)

- Repeat Finding
Requirement
N
Questioned Costs
$1
Year
2024
Accepted
2025-03-25
Audit: 348113
Organization: State of Nebraska (NE)

AI Summary

  • Core Issue: Two out of 20 reviewed cases lacked timely documentation and adherence to policies, leading to unresolved overpayments and a repeat finding from the previous audit.
  • Impacted Requirements: Compliance with 42 CFR § 455.1 and § 455.14 regarding fraud investigation procedures and timely case management.
  • Recommended Follow-Up: Enhance internal controls to ensure timely case reviews and documentation, and address the repeat findings in the Summary Schedule of Prior Audit Findings.

Finding Text

Program: AL 93.778 – Medical Assistance Program – Special Tests and Provisions Grant Number & Year: 2405NE5MAP, FFY 2024 Federal Grantor Agency: U.S. Department of Health and Human Services Criteria: Title 42 CFR § 455.1 (October 1, 2023) sets forth requirements for a State fraud detection and investigation program, including a method to verify whether services reimbursed by Medicaid were actually furnished to beneficiaries. The Agency’s Program Integrity (PI) and Special Investigations Units (SIU) perform these functions. Per 42 CFR § 455.14 (October 1, 2023): If the agency receives a complaint of Medicaid fraud or abuse from any source or identifies any questionable practices, it must conduct a preliminary investigation to determine whether there is sufficient basis to warrant a full investigation. The Nebraska Medicaid State Plan, Section 4.5 (Medicaid Agency Fraud Detection and Investigation Program), states, “The Medicaid agency has established and will maintain methods, criteria and procedures that meet all requirements of 42 CFR 455.13 through 455.21 and 455.23 for prevention and control of program fraud and abuse.” Under PI’s Policies and Procedures: Full investigations • Each month, investigators will review their cases and use their professional judgment to determine the prioritization of their active cases. The following guidelines will be considered in this review: o The investigation of a provider for termination due to a finding on annual or monthly screening is a HIGH priority o Client health & safety influences the priority of a case o Definitive interpretation of regulations influences the priority of a case o Cases in the preliminary investigation phase are of a moderate priority PI’s Policies and Procedures also include the following under the Surveillance and Utilization Review Subsystem (SURS) Quarterly Sample Selection & Review Procedures: At the end of each calendar quarter, [a contractor] runs the Advantage Suite SURS reports . . . Effective with the reports received in January 2008, a minimum of three provider and three recipient cases will be opened from the SURS Ranking Reports sometime during the calendar quarter of January 1, 2008 – March 31, 2008 and for each quarter thereafter unless notified otherwise. Per Section V.O. (“Program Integrity”) of the contract between the State of Nebraska and each of the three Heritage Health Managed Care Organizations (MCOs): O.2. The MCO must pursue the recovery of overpayments identified as FWA after receiving permission from NMPI and reflect the recovery on the encounter record and other reports used for rate setting. In the event that the MCO does not pursue all recoveries, MLTC will pursue them and collect the money. A good internal control plan requires procedures to ensure that cases are reviewed, and adequately collected on, and appropriate dispositions are made in a timely manner. Title 42 CFR § 433.320(a)(1) (October 1, 2023) states the following: (1) The agency must refund the Federal share of overpayments that are subject to recovery to CMS through a credit on its Quarterly Statement of Expenditures (Form CMS-64). Title 45 CFR § 75.511(a) (October 1, 2023) requires the auditee to prepare a summary schedule of prior audit findings. Per subsection (b)(2) of that same regulation, “When audit findings were not corrected or were only partially corrected, the summary schedule must describe the reasons for the finding’s recurrence and planned corrective action, and any partial corrective action taken.” Condition: For 2 of the 20 PI cases tested, there was a lack of documentation to support that the cases were being worked timely. Additionally, policies and procedures to identify potential cases are not being followed, and an overpayment was not properly reported. A similar finding was noted in the prior audit. The Summary Schedule of Prior Audit Findings listed the status as completed. Repeat Finding: 2023-055 Questioned Costs: $23,120 known Statistical Sample: No Context: PI is tasked with, among other things, investigating cases of potential provider fraud in the Medicaid Program. Cases received are delegated to investigators who track their activity notes and documentation in one central Investigative Case Management system (ICM). Substantial cases with a large amount of money that may be due back will be referred to the Attorney General’s Medicaid Fraud and Patient Abuse Unit (MFPAU). In cases that are not referred and accepted by MFPAU, PI can sanction a provider, request a refund, provide education, and/or terminate the provider from the Medicaid Program. We tested 20 PI cases and noted the following: • One case opened in April 2023 was referred by a Managed Care Organization (MCO) for a provider potentially overbilling for Mental Health services and other “red flags,” including possible billing for therapy services provided to a household member, providing services through an unregistered business, not following proper diagnostic methods, and not complying with other required services through provider agreement with local Drug Court. The first investigator ran a background check on the provider and contacted the Nebraska Department of Labor, which stated there were no records of the provider using the social security number provided. That investigator left in October 2023, and the case was reassigned. The second investigator was contacted by the MCO in December 2023, requesting the provider to be removed from the network. From January 2024 to July 2024, the only updates on the case were notes indicating that the investigation was ongoing. The Agency could not provide support to show what the investigator had done in those six months to further the case. Communication was made to the other two MCOs in July 2024, requesting any additional information they may have on the provider. As of October 2024, at the time of field work, the case was still open, and the investigator was waiting for guidance on what to do next. • A case was referred to PI in November 2023 by a Managed Care Organization (MCO) for a provider potentially overbilling for medical services. The MCO’s investigative team found claims were not supported due to upcoding of the evaluation and management services, duplicate claims, and no records being provided for 69 claim lines. The MCO identified an overpayment, totaling $15,491, and requested approval to seek reimbursement. The MCO cannot seek reimbursement without State approval, as it could interfere with other investigations that may be occurring. From January 2024 to October 2024 (at the time of field work), the only actions taken on the case were background checks on the providers and searches for other businesses owned by the providers. We asked the Agency if any other documentation was available to show what actions had been taken on the case. The Agency indicated there was no other information on the case, and there is “no standard timing for requesting vetting information from the other two MCOs when a case originates with an MCO.” Furthermore, we noted that PI was not following current policies and procedures for identifying potential fraud, waste, and abuse. Its policies and procedures indicated it would review the statewide SURS report quarterly and “a minimum of three provider and three recipient cases will be opened from the SURS Ranking Reports.” Beginning January 2023, no cases were opened from the SURS report. This was noted in our prior audit, and the Agency indicated it would be updating its policies and procedures; however, this was not completed as of June 2024. The Agency noted during our current audit that the SURS reporting mechanism was not functioning as designed, so it will be searching for a replacement fraud abuse detection system and will use other methods to identify potential fraud, waste, and abuse. In addition, we noted one of four overpayments tested was not properly reported. • In November 2020, PI started a project to analyze the MCO for dental services for excessive reimbursements. The initial overpayment was calculated at $237,633; however, in July 2023, a settlement was reached between PI and the MCO for $52,308. It was noted in the case that this amount was all Federal dollars and should be returned as such. The refund was received in August 2023 and reported on the quarter ended September 30, 2023, CMS-64 report. However, the refund was reported as $23,120 State and $29,188 Federal funds. The $23,120 not included in the Federal portion is considered questioned costs. Cause: The Agency did not follow proper procedures, including supervisor reviews of cases, to ensure Medicaid cases were properly and timely worked. The PI unit is understaffed. Clerical error by Finance staff in reporting overpayment. Effect: When potential fraud cases are not adequately and timely pursued, there is an increased risk for misuse of funds and potential harm to individuals receiving services. Recommendation: We recommend the Agency strengthen procedures to ensure cases are properly and timely reviewed, and appropriate dispositions are made. We further recommend the Agency strengthen procedures to ensure overpayments are accurately reported. Management Response: Management partially agrees. For the two cases listed, these cases should have been worked in a timelier manner. For the reporting of cases using exception reporting, the reports developed by the Department’s contractor for Fraud Abuse Detection reporting were consistently found to be inaccurate. Program Integrity leadership found that the reports were presenting false positives for cases. During this time frame, the Program Integrity team was addressing cases identified through the previous findings related to EVV and was working on other ways to identify providers that were different from their peers. APA Response: No cases were opened from the exception reports, and the Agency did not have alternate policies in place during the fiscal year.

Corrective Action Plan

Program: AL 93.778 – Medical Assistance Program – Special Tests and Provisions Corrective Action Plan: Program Integrity staff will continue to attempt to update cases at least every 30 days when case totals are at or below 25 and every 45 days when higher than 25. Trainings and regular conversations emphasize the need for descriptive narrative entries. As a result, the narrative entries will be more descriptive of the status of the case. For the exception reporting, the team continues to work on developing alternatives to using the reports in the Fraud Abuse Detection System. Concerning the misreported check, Program Integrity staff will give the Financial Team accurate information about collected refunds. The Department will ensure reports are accurate and make any necessary adjustments. Contact: Anne Harvey, Heather Arnold Anticipated Completion Date: 6/30/2025

Categories

Questioned Costs Special Tests & Provisions Allowable Costs / Cost Principles Cash Management HUD Housing Programs Reporting Internal Control / Segregation of Duties

Other Findings in this Audit

  • 529989 2024-030
    Significant Deficiency Repeat
  • 529990 2024-030
    Significant Deficiency Repeat
  • 529991 2024-037
    Significant Deficiency Repeat
  • 529992 2024-038
    Significant Deficiency Repeat
  • 529993 2024-039
    - Repeat
  • 529994 2024-031
    - Repeat
  • 529995 2024-031
    - Repeat
  • 529996 2024-031
    - Repeat
  • 529997 2024-031
    - Repeat
  • 529998 2024-031
    - Repeat
  • 529999 2024-066
    - Repeat
  • 530000 2024-032
    -
  • 530001 2024-033
    -
  • 530002 2024-034
    -
  • 530003 2024-035
    - Repeat
  • 530004 2024-037
    Significant Deficiency Repeat
  • 530005 2024-038
    Significant Deficiency Repeat
  • 530006 2024-041
    - Repeat
  • 530007 2024-038
    Significant Deficiency Repeat
  • 530008 2024-030
    Significant Deficiency Repeat
  • 530009 2024-037
    Significant Deficiency Repeat
  • 530010 2024-038
    Significant Deficiency Repeat
  • 530011 2024-042
    Material Weakness Repeat
  • 530012 2024-043
    Material Weakness Repeat
  • 530013 2024-044
    -
  • 530014 2024-037
    Significant Deficiency Repeat
  • 530015 2024-038
    Significant Deficiency Repeat
  • 530016 2024-037
    Significant Deficiency Repeat
  • 530017 2024-038
    Significant Deficiency Repeat
  • 530018 2024-039
    - Repeat
  • 530019 2024-045
    Material Weakness Repeat
  • 530020 2024-046
    Significant Deficiency Repeat
  • 530021 2024-045
    Material Weakness Repeat
  • 530022 2024-047
    Material Weakness Repeat
  • 530023 2024-048
    Material Weakness Repeat
  • 530024 2024-045
    Material Weakness Repeat
  • 530025 2024-046
    Significant Deficiency Repeat
  • 530026 2024-037
    Significant Deficiency Repeat
  • 530027 2024-038
    Significant Deficiency Repeat
  • 530028 2024-040
    Material Weakness Repeat
  • 530029 2024-049
    Significant Deficiency
  • 530030 2024-050
    Significant Deficiency Repeat
  • 530031 2024-050
    Significant Deficiency Repeat
  • 530032 2024-037
    Significant Deficiency Repeat
  • 530033 2024-038
    Significant Deficiency Repeat
  • 530034 2024-051
    Significant Deficiency
  • 530035 2024-052
    Significant Deficiency Repeat
  • 530036 2024-037
    Significant Deficiency Repeat
  • 530037 2024-038
    Significant Deficiency Repeat
  • 530038 2024-038
    Significant Deficiency Repeat
  • 530039 2024-039
    - Repeat
  • 530040 2024-055
    - Repeat
  • 530041 2024-056
    - Repeat
  • 530042 2024-058
    Significant Deficiency
  • 530043 2024-029
    - Repeat
  • 530044 2024-037
    Significant Deficiency Repeat
  • 530045 2024-038
    Significant Deficiency Repeat
  • 530046 2024-039
    - Repeat
  • 530047 2024-053
    Significant Deficiency Repeat
  • 530048 2024-054
    Significant Deficiency Repeat
  • 530049 2024-055
    - Repeat
  • 530050 2024-056
    - Repeat
  • 530052 2024-058
    Significant Deficiency
  • 530053 2024-053
    Significant Deficiency Repeat
  • 530054 2024-039
    - Repeat
  • 530055 2024-059
    Significant Deficiency
  • 530056 2024-060
    -
  • 530057 2024-071
    - Repeat
  • 530058 2024-036
    -
  • 530059 2024-061
    Material Weakness Repeat
  • 530060 2024-062
    -
  • 530061 2024-064
    Significant Deficiency
  • 530062 2024-065
    Significant Deficiency
  • 530063 2024-063
    -
  • 530064 2024-073
    - Repeat
  • 530065 2024-067
    Material Weakness Repeat
  • 530066 2024-068
    -
  • 530067 2024-069
    Material Weakness Repeat
  • 530068 2024-070
    Significant Deficiency Repeat
  • 530069 2024-072
    Material Weakness
  • 1106431 2024-030
    Significant Deficiency Repeat
  • 1106432 2024-030
    Significant Deficiency Repeat
  • 1106433 2024-037
    Significant Deficiency Repeat
  • 1106434 2024-038
    Significant Deficiency Repeat
  • 1106435 2024-039
    - Repeat
  • 1106436 2024-031
    - Repeat
  • 1106437 2024-031
    - Repeat
  • 1106438 2024-031
    - Repeat
  • 1106439 2024-031
    - Repeat
  • 1106440 2024-031
    - Repeat
  • 1106441 2024-066
    - Repeat
  • 1106442 2024-032
    -
  • 1106443 2024-033
    -
  • 1106444 2024-034
    -
  • 1106445 2024-035
    - Repeat
  • 1106446 2024-037
    Significant Deficiency Repeat
  • 1106447 2024-038
    Significant Deficiency Repeat
  • 1106448 2024-041
    - Repeat
  • 1106449 2024-038
    Significant Deficiency Repeat
  • 1106450 2024-030
    Significant Deficiency Repeat
  • 1106451 2024-037
    Significant Deficiency Repeat
  • 1106452 2024-038
    Significant Deficiency Repeat
  • 1106453 2024-042
    Material Weakness Repeat
  • 1106454 2024-043
    Material Weakness Repeat
  • 1106455 2024-044
    -
  • 1106456 2024-037
    Significant Deficiency Repeat
  • 1106457 2024-038
    Significant Deficiency Repeat
  • 1106458 2024-037
    Significant Deficiency Repeat
  • 1106459 2024-038
    Significant Deficiency Repeat
  • 1106460 2024-039
    - Repeat
  • 1106461 2024-045
    Material Weakness Repeat
  • 1106462 2024-046
    Significant Deficiency Repeat
  • 1106463 2024-045
    Material Weakness Repeat
  • 1106464 2024-047
    Material Weakness Repeat
  • 1106465 2024-048
    Material Weakness Repeat
  • 1106466 2024-045
    Material Weakness Repeat
  • 1106467 2024-046
    Significant Deficiency Repeat
  • 1106468 2024-037
    Significant Deficiency Repeat
  • 1106469 2024-038
    Significant Deficiency Repeat
  • 1106470 2024-040
    Material Weakness Repeat
  • 1106471 2024-049
    Significant Deficiency
  • 1106472 2024-050
    Significant Deficiency Repeat
  • 1106473 2024-050
    Significant Deficiency Repeat
  • 1106474 2024-037
    Significant Deficiency Repeat
  • 1106475 2024-038
    Significant Deficiency Repeat
  • 1106476 2024-051
    Significant Deficiency
  • 1106477 2024-052
    Significant Deficiency Repeat
  • 1106478 2024-037
    Significant Deficiency Repeat
  • 1106479 2024-038
    Significant Deficiency Repeat
  • 1106480 2024-038
    Significant Deficiency Repeat
  • 1106481 2024-039
    - Repeat
  • 1106482 2024-055
    - Repeat
  • 1106483 2024-056
    - Repeat
  • 1106484 2024-058
    Significant Deficiency
  • 1106485 2024-029
    - Repeat
  • 1106486 2024-037
    Significant Deficiency Repeat
  • 1106487 2024-038
    Significant Deficiency Repeat
  • 1106488 2024-039
    - Repeat
  • 1106489 2024-053
    Significant Deficiency Repeat
  • 1106490 2024-054
    Significant Deficiency Repeat
  • 1106491 2024-055
    - Repeat
  • 1106492 2024-056
    - Repeat
  • 1106493 2024-057
    - Repeat
  • 1106494 2024-058
    Significant Deficiency
  • 1106495 2024-053
    Significant Deficiency Repeat
  • 1106496 2024-039
    - Repeat
  • 1106497 2024-059
    Significant Deficiency
  • 1106498 2024-060
    -
  • 1106499 2024-071
    - Repeat
  • 1106500 2024-036
    -
  • 1106501 2024-061
    Material Weakness Repeat
  • 1106502 2024-062
    -
  • 1106503 2024-064
    Significant Deficiency
  • 1106504 2024-065
    Significant Deficiency
  • 1106505 2024-063
    -
  • 1106506 2024-073
    - Repeat
  • 1106507 2024-067
    Material Weakness Repeat
  • 1106508 2024-068
    -
  • 1106509 2024-069
    Material Weakness Repeat
  • 1106510 2024-070
    Significant Deficiency Repeat
  • 1106511 2024-072
    Material Weakness

Programs in Audit

ALN Program Name Expenditures
10.551 Supplemental Nutrition Assistance Program $310.78M
21.027 Coronavirus State and Local Fiscal Recovery Funds $214.16M
97.036 Disaster Grants - Public Assistance (presidentially Declared Disasters) $76.85M
84.010 Title I Grants to Local Educational Agencies $57.45M
93.558 Temporary Assistance for Needy Families $48.17M
93.575 Child Care and Development Block Grant $48.05M
12.401 National Guard Military Operations and Maintenance (o&m) Projects $36.95M
10.557 Wic Special Supplemental Nutrition Program for Women, Infants, and Children $34.45M
66.468 Drinking Water State Revolving Fund $33.99M
21.029 Coronavirus Capital Projects Fund $29.75M
93.596 Child Care Mandatory and Matching Funds of the Child Care and Development Fund $28.69M
10.558 Child and Adult Care Food Program $28.62M
10.553 School Breakfast Program $27.93M
64.015 Veterans State Nursing Home Care $25.90M
93.778 Medical Assistance Program $23.99M
93.563 Child Support Services $23.93M
93.323 Epidemiology and Laboratory Capacity for Infectious Diseases (elc) $23.75M
12.400 Military Construction, National Guard $22.76M
10.542 Pandemic Ebt Food Benefits $20.61M
10.555 National School Lunch Program $18.26M
93.566 Refugee and Entrant Assistance State/replacement Designee Administered Programs $17.19M
21.026 Homeowner Assistance Fund $14.73M
66.458 Clean Water State Revolving Fund $14.24M
21.023 Emergency Rental Assistance Program $14.17M
96.001 Social Security Disability Insurance $14.01M
15.611 Wildlife Restoration and Basic Hunter Education and Safety $13.38M
93.667 Social Services Block Grant $12.32M
20.106 Airport Improvement Program, Infrastructure Investment and Jobs Act Programs, and Covid-19 Airports Programs $11.94M
10.569 Emergency Food Assistance Program (food Commodities) $10.69M
16.575 Crime Victim Assistance $10.43M
93.917 Hiv Care Formula Grants $9.64M
93.268 Immunization Cooperative Agreements $9.02M
10.646 Summer Electronic Benefit Transfer Program for Children $8.95M
84.048 Career and Technical Education -- Basic Grants to States $8.82M
15.018 Energy Community Revitalization Program (ecrp) $8.58M
84.369 Grants for State Assessments and Related Activities $8.05M
84.367 Supporting Effective Instruction State Grants (formerly Improving Teacher Quality State Grants) $7.62M
93.391 Activities to Support State, Tribal, Local and Territorial (stlt) Health Department Response to Public Health Or Healthcare Crises $7.18M
84.011 Migrant Education State Grant Program $7.16M
93.434 Every Student Succeeds Act/preschool Development Grants $7.14M
15.605 Sport Fish Restoration $7.02M
21.U01 State Small Business Credit Initiative (ssbci) $6.17M
20.205 Highway Planning and Construction $6.10M
84.287 Twenty-First Century Community Learning Centers $5.79M
93.569 Community Services Block Grant $5.59M
93.069 Public Health Emergency Preparedness $5.33M
17.207 Employment Service/wagner-Peyser Funded Activities $5.28M
20.933 National Infrastructure Investments $5.28M
97.067 Homeland Security Grant Program $4.75M
84.027 Special Education Grants to States $4.64M
84.126 Rehabilitation Services Vocational Rehabilitation Grants to States $4.53M
14.239 Home Investment Partnerships Program $4.38M
20.218 Motor Carrier Safety Assistance $4.24M
14.275 Housing Trust Fund $4.19M
93.994 Maternal and Child Health Services Block Grant to the States $3.86M
20.600 State and Community Highway Safety $3.82M
93.354 Public Health Emergency Response: Cooperative Agreement for Emergency Response: Public Health Crisis Response $3.76M
17.259 Wioa Youth Activities $3.73M
16.554 National Criminal History Improvement Program (nchip) $3.63M
93.568 Low-Income Home Energy Assistance $3.61M
93.136 Injury Prevention and Control Research and State and Community Based Programs $3.59M
84.002 Adult Education - Basic Grants to States $3.55M
81.042 Weatherization Assistance for Low-Income Persons $3.17M
10.559 Summer Food Service Program for Children $3.13M
20.616 National Priority Safety Programs $3.11M
14.228 Community Development Block Grants/state's Program and Non-Entitlement Grants in Hawaii $3.10M
64.005 Grants to States for Construction of State Home Facilities $2.96M
84.365 English Language Acquisition State Grants $2.87M
93.788 Opioid Str $2.85M
10.582 Fresh Fruit and Vegetable Program $2.57M
66.460 Nonpoint Source Implementation Grants $2.45M
17.258 Wioa Adult Program $2.41M
15.916 Outdoor Recreation Acquisition, Development and Planning $2.31M
93.243 Substance Abuse and Mental Health Services Projects of Regional and National Significance $2.26M
93.991 Preventive Health and Health Services Block Grant $2.24M
20.237 Motor Carrier Safety Assistance High Priority Activities Grants and Cooperative Agreements $2.02M
97.045 Cooperating Technical Partners $1.99M
93.898 Cancer Prevention and Control Programs for State, Territorial and Tribal Organizations $1.98M
10.565 Commodity Supplemental Food Program $1.89M
17.278 Wioa Dislocated Worker Formula Grants $1.85M
93.556 Marylee Allen Promoting Safe and Stable Families Program $1.85M
11.035 Broadband Equity, Access, and Deployment Program $1.84M
45.310 Grants to States $1.84M
93.767 Children's Health Insurance Program $1.81M
93.645 Stephanie Tubbs Jones Child Welfare Services Program $1.78M
11.307 Economic Adjustment Assistance $1.77M
64.014 Veterans State Domiciliary Care $1.67M
20.200 Highway Research and Development Program $1.64M
84.421 Disability Innovation Fund (dif) $1.55M
93.674 John H. Chafee Foster Care Program for Successful Transition to Adulthood $1.43M
94.006 Americorps State and National 94.006 $1.41M
64.203 Veterans Cemetery Grants Program $1.34M
16.606 State Criminal Alien Assistance Program $1.26M
17.225 Unemployment Insurance $1.24M
10.561 State Administrative Matching Grants for the Supplemental Nutrition Assistance Program $1.23M
45.025 Promotion of the Arts Partnership Agreements $1.20M
15.634 State Wildlife Grants $1.16M
16.813 Nics Act Record Improvement Program $1.14M
95.001 High Intensity Drug Trafficking Areas Program $1.13M
93.044 Special Programs for the Aging, Title Iii, Part B, Grants for Supportive Services and Senior Centers $1.11M
93.241 State Rural Hospital Flexibility Program $1.10M
10.025 Plant and Animal Disease, Pest Control, and Animal Care $1.09M
93.045 Special Programs for the Aging, Title Iii, Part C, Nutrition Services $1.08M
84.368 Competitive Grants for State Assessments $1.08M
66.805 Leaking Underground Storage Tank Trust Fund Corrective Action Program $1.04M
93.775 State Medicaid Fraud Control Units $1.04M
93.747 Elder Abuse Prevention Interventions Program $1.02M
16.588 Violence Against Women Formula Grants $1.02M
93.671 Family Violence Prevention and Services/domestic Violence Shelter and Supportive Services $1.01M
10.170 Specialty Crop Block Grant Program - Farm Bill $1.01M
93.387 National and State Tobacco Control Program $1.01M
93.967 Centers for Disease Control and Prevention Collaboration with Academia to Strengthen Public Health $985,409
14.241 Housing Opportunities for Persons with Aids $983,410
97.008 Non-Profit Security Program $979,226
15.904 Historic Preservation Fund Grants-in-Aid $946,365
93.053 Nutrition Services Incentive Program $932,713
17.801 Jobs for Veterans State Grants $922,465
93.977 Sexually Transmitted Diseases (std) Prevention and Control Grants $907,184
93.110 Maternal and Child Health Federal Consolidated Programs $894,122
20.509 Formula Grants for Rural Areas and Tribal Transit Program $864,166
93.940 Hiv Prevention Activities Health Department Based $859,152
93.301 Small Rural Hospital Improvement Grant Program $841,836
20.505 Metropolitan Transportation Planning and State and Non-Metropolitan Planning and Research $818,850
66.442 Water Infrastructure Improvements for the Nation Small and Underserved Communities Emerging Contaminants Grant Program $790,946
16.741 Dna Backlog Reduction Program $774,154
66.817 State and Tribal Response Program Grants $757,677
17.002 Labor Force Statistics $749,357
93.165 Grants to States for Loan Repayment $718,744
17.235 Senior Community Service Employment Program $715,845
93.959 Block Grants for Prevention and Treatment of Substance Abuse $709,005
93.464 Acl Assistive Technology $698,265
93.103 Food and Drug Administration Research $673,594
93.336 Behavioral Risk Factor Surveillance System $671,465
97.012 Boating Safety Financial Assistance $671,428
97.039 Hazard Mitigation Grant $664,076
81.041 State Energy Program $653,712
15.608 Fish and Aquatic Conservation - Aquatic Invasive Species $651,598
93.436 Well-Integrated Screening and Evaluation for Women Across the Nation (wisewoman) $631,891
17.504 Consultation Agreements $628,409
20.219 Recreational Trails Program $604,987
66.040 Diesel Emissions Reduction Act (dera) State Grants $598,470
84.323 Special Education - State Personnel Development $579,905
10.560 State Administrative Expenses for Child Nutrition $576,032
30.001 Employment Discrimination Title Vii of the Civil Rights Act of 1964 $575,820
84.184 School Safely National Activities $536,088
84.181 Special Education-Grants for Infants and Families $528,612
15.524 Recreation Resources Management $508,452
66.034 Surveys, Studies, Research, Investigations, Demonstrations, and Special Purpose Activities Relating to the Clean Air Act $505,499
93.659 Adoption Assistance $502,097
17.245 Trade Adjustment Assistance $500,140
93.472 Title IV-E Prevention Program $491,005
97.041 National Dam Safety Program $489,894
93.800 Organized Approaches to Increase Colorectal Cancer Screening $487,606
97.042 Emergency Management Performance Grants $479,246
93.070 Environmental Public Health and Emergency Response $477,377
14.231 Emergency Solutions Grant Program $468,523
84.425 Education Stabilization Fund $465,758
16.017 Sexual Assault Services Formula Program $464,134
90.404 Hava Election Security Grants $463,691
39.003 Donation of Federal Surplus Personal Property $462,019
93.958 Block Grants for Community Mental Health Services $457,125
93.324 State Health Insurance Assistance Program $447,433
66.447 Sewer Overflow and Stormwater Reuse Municipal Grant Program $441,000
97.023 Community Assistance Program State Support Services Element (cap-Ssse) $440,333
66.802 Superfund State, Political Subdivision, and Indian Tribe Site-Specific Cooperative Agreements $438,810
20.700 Pipeline Safety Program State Base Grant $436,143
10.649 Pandemic Ebt Administrative Costs $431,980
93.586 State Court Improvement Program $430,726
97.137 State and Local Cybersecurity Grant Program Tribal Cybersecurity Grant Program $428,150
84.196 Education for Homeless Children and Youth $426,540
66.804 Underground Storage Tank (ust) Prevention, Detection, and Compliance Program $422,626
93.497 Family Violence Prevention and Services/ Sexual Assault/rape Crisis Services and Supports $409,737
93.116 Project Grants and Cooperative Agreements for Tuberculosis Control Programs $408,583
66.046 Climate Pollution Reduction Grants $407,891
93.197 Childhood Lead Poisoning Prevention Projects, State and Local Childhood Lead Poisoning Prevention and Surveillance of Blood Lead Levels in Children $396,844
84.173 Special Education Preschool Grants $389,371
16.320 Services for Trafficking Victims $387,580
16.543 Missing Children's Assistance $383,300
93.603 Adoption and Legal Guardianship Incentive Payments Program $371,219
93.946 Cooperative Agreements to Support State-Based Safe Motherhood and Infant Health Initiative Programs $367,220
94.003 Americorps State Commissions Support Grant $366,646
93.426 The National Cardiovascular Health Program $362,380
11.032 State Digital Equity Planning and Capacity Grant $361,089
93.599 Chafee Education and Training Vouchers Program (etv) $352,014
84.372 Statewide Longitudinal Data Systems $348,665
10.568 Emergency Food Assistance Program (administrative Costs) $338,912
93.988 Cooperative Agreements for Diabetes Control Programs $331,267
93.092 Affordable Care Act (aca) Personal Responsibility Education Program $305,281
93.236 Grants to States to Support Oral Health Workforce Activities $296,454
97.047 Bric: Building Resilient Infrastructure and Communities $289,175
14.401 Fair Housing Assistance Program $288,560
59.061 State Trade Expansion $286,911
16.738 Edward Byrne Memorial Justice Assistance Grant Program $286,681
93.150 Projects for Assistance in Transition From Homelessness (path) $285,627
66.605 Performance Partnership Grants $277,132
84.187 Supported Employment Services for Individuals with the Most Significant Disabilities $270,000
16.750 Support for Adam Walsh Act Implementation Grant Program $266,548
93.048 Special Programs for the Aging, Title Iv, and Title Ii, Discretionary Projects $263,927
66.419 Water Pollution Control State, Interstate, and Tribal Program Support $263,861
12.112 Payments to States in Lieu of Real Estate Taxes $259,512
96.006 Supplemental Security Income $258,965
16.922 Equitable Sharing Program $258,564
93.235 Title V State Sexual Risk Avoidance Education (title V State Srae) Program $256,134
93.052 National Family Caregiver Support, Title Iii, Part E $246,346
93.071 Medicare Enrollment Assistance Program $234,022
10.579 Child Nutrition Discretionary Grants Limited Availability $225,899
17.271 Work Opportunity Tax Credit Program (wotc) $220,035
93.658 Foster Care Title IV-E $218,958
10.093 Voluntary Public Access and Habitat Incentive Program $213,757
16.754 Harold Rogers Prescription Drug Monitoring Program $208,550
16.742 Paul Coverdell Forensic Sciences Improvement Grant Program $207,810
93.251 Early Hearing Detection and Intervention $207,653
93.079 Cooperative Agreements to Promote Adolescent Health Through School-Based Hiv/std Prevention and School-Based Surveillance $205,949
10.185 Local Food for Schools Cooperative Agreement Program $195,203
10.574 Team Nutrition Grants $190,829
10.576 Senior Farmers Market Nutrition Program $189,630
17.273 Temporary Labor Certification for Foreign Workers $188,942
93.262 Occupational Safety and Health Program $184,782
93.913 Grants to States for Operation of State Offices of Rural Health $183,226
16.827 Justice Reinvestment Initiative $183,059
16.839 Stop School Violence $180,156
10.666 Schools and Roads - Grants to Counties $177,159
93.817 Hospital Preparedness Program (hpp) Ebola Preparedness and Response Activities $175,347
93.413 The State Flexibility to Stabilize the Market Grant Program $174,507
64.U01 Cooperative Agreement for Veteran Training Program $168,369
84.161 Rehabilitation Services Client Assistance Program $167,696
66.032 State and Tribal Indoor Radon Grants $164,697
93.279 Drug Use and Addiction Research Programs $163,584
84.013 Title I State Agency Program for Neglected and Delinquent Children and Youth $155,085
16.812 Second Chance Act Reentry Initiative $150,873
10.U01 Nebraska Rural Rehabilitation Program $148,019
93.270 Viral Hepatitis Prevention and Control $134,993
94.009 Training and Technical Assistance $134,328
20.611 Incentive Grant Program to Prohibit Racial Profiling $130,163
84.325 Special Education - Personnel Development to Improve Services and Results for Children with Disabilities $129,880
93.314 Early Hearing Detection and Intervention Information System (ehdi-Is) Surveillance Program $129,574
66.454 Water Quality Management Planning $129,102
16.576 Crime Victim Compensation $127,483
10.578 Wic Grants to States (wgs) $127,309
93.435 The Innovative Cardiovascular Health Program $127,027
93.600 Head Start $126,610
84.358 Rural Education $122,557
93.643 Children's Justice Grants to States $121,882
10.575 Farm to School Grant Program $120,179
93.870 Maternal, Infant and Early Childhood Home Visiting Grant $115,679
93.547 National Health Service Corps $113,833
15.669 Cooperative Landscape Conservation $112,427
10.435 State Mediation Grants $111,515
93.127 Emergency Medical Services for Children $110,328
20.232 Commercial Driver's License Program Implementation Grant $103,335
66.608 Environmental Information Exchange Network Grant Program and Related Assistance $103,032
84.177 Rehabilitation Services Independent Living Services for Older Individuals Who Are Blind $102,461
93.597 Grants to States for Access and Visitation Programs $99,628
93.734 Empowering Older Adults and Adults with Disabilities Through Chronic Disease Self-Management Education Programs – Financed by Prevention and Public Health Funds (pphf) $98,762
12.113 State Memorandum of Agreement Program for the Reimbursement of Technical Services $92,590
10.182 Pandemic Relief Activities: Local Food Purchase Agreements with States, Tribes, and Local Governments $84,836
16.540 Juvenile Justice and Delinquency Prevention $80,660
93.043 Special Programs for the Aging, Title Iii, Part D, Disease Prevention and Health Promotion Services $79,248
20.614 National Highway Traffic Safety Administration (nhtsa) Discretionary Safety Grants and Cooperative Agreements $78,000
32.U01 Fcc - Certification $76,287
16.710 Public Safety Partnership and Community Policing Grants $74,748
20.703 Interagency Hazardous Materials Public Sector Training and Planning Grants $72,708
93.U01 Medicated Feed Inspection Contract $71,046
20.224 Federal Lands Access Program $70,418
10.603 Emerging Markets Program $68,860
84.424 Student Support and Academic Enrichment Program $67,049
15.626 Enhanced Hunter Education and Safety $66,175
93.630 Developmental Disabilities Basic Support and Advocacy Grants $56,216
66.444 Voluntary School and Child Care Lead Testing and Reduction Grant Program (sdwa 1464(d)) $55,105
93.042 Special Programs for the Aging, Title Vii, Chapter 2, Long Term Care Ombudsman Services for Older Individuals $50,435
10.190 Resilient Food System Infrastructure Program $48,877
16.582 Crime Victim Assistance/discretionary Grants $47,065
84.144 Migrant Education Coordination Program $46,330
93.234 Traumatic Brain Injury State Demonstration Grant Program $45,588
66.433 State Underground Water Source Protection $42,912
93.421 Strengthening Public Health Systems and Services Through National Partnerships to Improve and Protect the Nation’s Health $41,060
15.615 Cooperative Endangered Species Conservation Fund $38,151
93.669 Child Abuse and Neglect State Grants $37,116
17.005 Compensation and Working Conditions $36,599
20.513 Enhanced Mobility of Seniors and Individuals with Disabilities $36,251
10.556 Special Milk Program for Children $36,026
10.932 Regional Conservation Partnership Program $35,997
15.946 Cultural Resources Management $35,571
97.029 Flood Mitigation Assistance $32,250
10.U02 Hazardous Waste Management $30,945
97.043 State Fire Training Systems Grants $28,384
45.312 National Leadership Grants $28,183
10.645 Farm to School State Formula Grant $23,199
89.003 National Historical Publications and Records Grants $20,746
16.550 State Justice Statistics Program for Statistical Analysis Centers $19,923
93.041 Special Programs for the Aging, Title Vii, Chapter 3, Programs for Prevention of Elder Abuse, Neglect, and Exploitation $19,146
84.326 Special Education Technical Assistance and Dissemination to Improve Services and Results for Children with Disabilities $15,857
66.432 State Public Water System Supervision $15,529
10.931 Agricultural Conservation Easement Program $14,155
66.920 Solid Waste Infrastructure for Recycling Infrastructure Grants $13,597
81.128 Energy Efficiency and Conservation Block Grant Program (eecbg) $12,915
81.254 Grid Infrastructure Deployment and Resilience $12,629
10.477 Meat, Poultry, and Egg Products Inspection $11,795
15.511 Cultural Resources Management $10,650
66.820 State Programs for Control of Coal Combustion Residuals $9,134
93.090 Guardianship Assistance $8,112
15.637 Migratory Bird Joint Ventures $7,078
93.130 Cooperative Agreements to States/territories for the Coordination and Development of Primary Care Offices $5,495
81.138 State Heating Oil and Propane Program $4,959
93.U03 Food Inspection Contract $4,189
16.U01 Dea Grants $3,586
15.517 Fish and Wildlife Coordination Act $2,875
84.310 Statewide Family Engagement Centers $1,736
16.593 Residential Substance Abuse Treatment for State Prisoners $399
10.072 Wetlands Reserve Program $178
93.777 State Survey and Certification of Health Care Providers and Suppliers (title Xviii) Medicare $160
15.631 Partners for Fish and Wildlife $12
93.981 Improving Student Health and Academic Achievement Through Nutrition, Physical Activity and the Management of Chronic Conditions in Schools $-12
97.044 Assistance to Firefighters Grant $-255
93.889 National Bioterrorism Hospital Preparedness Program $-9,275