Office of the National Ombudsman

Department of Health and Human Services (HHS)

Centers for Medicare and Medicaid Services (CMS)

• Issue: Eighteen medical providers based in OH, MI, PA, GA, IN, and CO expressed concerns regarding denial, non-payment, and delay in the processing of Medicare claims by Medicare Advantage Organizations due to a variety of common and incorrect reasons.
• Outcome: Upon receiving a request for a high-level review by the Office of the National Ombudsman, the Centers for Medicare and Medicaid Services completed a high-level review of the records reviewed information provided by the Medicare Advantage Organizations. As a result, the Centers for Medicare and Medicaid Services ensured that the Medicare claims were reprocessed, enabling the eighteen providers to recover over $592,000.

Centers for Medicare and Medicaid Services (CMS)

• Issue: A Medicare Advantage Organization failed to make payments to a cancer treatment center even after it had authorized the treatments.
• Outcome: Upon receiving a request for a high-level review by the Office of the National Ombudsman, the Center for Medicare and Medicaid Services decided in favor of the small business. The Medicare Advantage Organization reprocessed three claims and paid the $19,270 owed.

Department of Defense (DOD)

Air Force

• Issue: A small business owner contacted the Office of the National Ombudsman regarding $266,000 allegedly owed to his company by Air Force Space Command for work completed 18 months prior. The business owner asserted that the contract was fully funded, there was no dispute that the work had been authorized and properly performed, and that payment was due. Despite frequent inquiries over more than a year, the small business owner was able to learn only that the matter was “in reconciliation” and was unable to ascertain any time frame for its resolution. In his comment, the business owner wrote: "Despite almost weekly calls...by our accounting department, we can make no progress and can’t even get a date or a single point of contact with whom we can work. The total owed is $266,603 and for a small business, that is a lot of money."
• Outcome: The Office of the National Ombudsman immediately contacted the DOD. Upon their review of the case, and within five weeks, payment of $265,900 was authorized.

U.S. Army Corps of Engineers (USACE)

• Issue: A landscaping and construction company was in discussion with USACE about a no-cost settlement due to the constant threat of termination, as well as the need for payment to the company.
• Outcome: Upon receiving a request for a high-level review by the Office of the National Ombudsman, USACE and the business reached a legal settlement of the matters raised, resulting in further payment of $375,000.

Defense Logistics Agency (DLA)

• Issue: An industrial spill kit supplier made several requests to the DLA for payment for goods delivered. Despite having presented proof of delivery paperwork to the contract specialist, the issue remained unresolved.
• Outcome: Upon receipt of the Office of the National Ombudsman’s request for a high-level review, the DLA located the misplaced goods and paid the invoice.

Navy

• Issue: A construction company filed a complaint with the Office of the National Ombudsman after experiencing a long delay in receiving payment from the Navy for work performed.
• Outcome: Upon receipt of the Office of the National Ombudsman’s request for a high-level review, the Navy issued a payment of the approximately $1,200,000 owed.

Army

• Issue: A small business government contractor expressed concerns regarding non-payment of invoices by the Army. The contract had been performed, inspected, and reports submitted; however, the Army had made partial payments and repeatedly rejected invoices for the remainder of the payments, only providing unclear comments and requesting additional documents that the small business had already submitted.
• Outcome: Upon receiving a request for a high-level review by the Office of the National Ombudsman, the Army determined that the invoices submitted would be approved for payment. The agency also determined that the company could submit a final invoice, as well as a claim for any additional cost incurred due to the delay in payment of the invoices in accordance with the Disputes Clause FAR 52.233-1.

Environmental Protection Agency (EPA)

• Issue: A small furniture store provided installation services to the EPA valued at $17,862. The agency’s non-payment of the invoice put a financial hardship on the small business.
• Outcome: Upon receiving a request for a high-level review by the Office of the National Ombudsman, the agency reviewed, approved, and paid the invoice in question for a total amount owed of $17,862.

Nuclear Regulatory Commission (NRC)

• Issue: A small business contractor to the NRC received a notice of a new wage determination for its contract. Within the 30-day deadline, the contractor submitted a revised proposal to its contracting officer based on the increased cost. The company explained that the Commission had not been responsive to their revised proposal. The company further explained that it paid the additional costs but had not been able to recuperate those costs through the contract.
• Outcome: Upon further review at the request of the Office of the National Ombudsman, the NRC modified the company’s contract to equitably adjust the labor rates based on the requirements of the applicable Department of Labor Service Contract Act wage determination that was made a part of the contract. Based on the wage determination, the company was able to submit an invoice for the additional costs incurred. The modification allowed the company to be paid the appropriate rates going forward.

Department of Defense (DOD)

• Issue: The owner of a small business in the textile industry was concerned when he was told that the quality control inspector/ auditor who had been assigned to an inspection had no experience with textiles. The inspector conducted the inspection and rejected an order for apparent defects, halting production and forcing the business to lay off and/or cut hours for 200 of its workers for a period of two months.
• Outcome: After contacting the Ombudsman’s Office for help, the DOD conducted a high-level review and the matter was resolved, enabling the small business to resume production.

Department of Veterans Affairs (VA)

• Issue: A small business contractor claimed that the decision by the VA's Center for Verification and Evaluation (CVE) to cancel the company’s veteran-owned certification was incorrect because it was based on an issue that was determined to be irrelevant in the past.
• Outcome: Upon further review at the request of the Office of the National Ombudsman and the engagement of the Small Business Administration, a review and audit found the company in compliance with certification regulations. With the Office of the National Ombudsman's assistance, the company received a letter from CVE to indicate that the certification remained verified in the VA's business database. As a result, the company was eligible to participate in contracting opportunities with the Department.

Department of Housing and Urban Development (HUD)

• Issue: A small business contractor to HUD reported that they disagreed with the Department’s assessment of the company in the Contractor Performance Assessment Reporting System, and asserted that they had completed all of their contract deliverables, went above and beyond, and exceeded expectations.
• Outcome: With the Office of the National Ombudsman's assistance and the information provided by the contractor, HUD revised its recommendation statement to indicate that the agency would recommend the company for similar requirements in the future.

Small Business Administration (SBA)

• Issue: A small business federal contractor objected to the hold that SBA placed on the company’s 8(a) contract certification status, which adversely impacted their ability to receive additional awards or assistance. The business owner contended that they were in compliance with 8(a) Program requirements and that the hold was a result of an administrative error by the company’s bookkeeper who mis-categorized two of the company’s contracts, which caused the company’s 8(a) revenue to appear too high. The business owner explained that the company had corrected the error and asked that the hold be removed from the company’s 8(a) status so that the company could continue to receive 8(a) contracts.
• Outcome: Upon further review at the request of the Office of the National Ombudsman, SBA resolved the issue so that the company was not under a contract prohibition.

Department of Homeland Security (DHS)

U.S. Citizenship and Immigration Services (USCIS)

• Issue: A small business seeking USCIS approval for an immigrant employment visa asserted that they had responded to the Request for Evidence (RFE) by the deadline, as evidenced by a FedEx Proof of Delivery. However, USCIS had erroneously denied the company’s Form I-140 based on abandonment.
• Outcome: Upon further review at the request of the Office of the National Ombudsman and with the small business's supporting documentation, USCIS approved the business’s Form I-140.

Department of Transportation (DOT)

Federal Motor Carrier Safety Administration (FCMSA)

• Issue: The owner of a cargo and freight company alleged that her company’s operating authority registration was revoked due to an error and without notice by the FCMSA. Though her operating authority registration had been reinstated, the registration record made it appear that the company was a new carrier. The business owner requested that the FCMSA remove all references to the erroneous revocation on its public websites.
• Outcome: After Office of the National Ombudsman intervened on behalf of the company, the FCMSA corrected the record in its Public Licensing and Insurance system, and the Office of Registration and Safety Information issued a refund of the reinstatement fee that the business owner was required to pay. Both the notice and decision revoking operating authority registration were removed from the company’s public record. The effective date for the company’s operating authority registration was corrected to properly reflect the motor carrier’s original registration date.

Small Business Administration (SBA)

• Issue: An auto body shop owner sought assistance in obtaining a refund of the $4,870 recoupment fee that was imposed by an SBA lender in connection with prepayment of an SBA-guaranteed commercial loan.
• Outcome: Working with the Office of the National Ombudsman, SBA found that the borrower’s prepayment had not been voluntary and authorized a refund of the full $4,870 recoupment fee.

Department of the Treasury

Internal Revenue Service (IRS)

• Issue: A biotechnology company requested an abatement by the IRS of the assessed penalties due to a misunderstanding and their limited knowledge of tax filing requirements.
• Outcome: Upon receiving a request for a high-level review by the Office of the National Ombudsman, the IRS looked into the issue and fully abated the penalty.

Department of Labor (DOL)

Occupational Safety and Health Administration (OSHA)

• Issue: OSHA inspected a dairy company and issued citations which the company asserted were not valid.
• Outcome: Based on the Office of the National Ombudsman's engagement, and a discussion with and further information provided by the company, OSHA reduced the overall penalty to $6,000 from the original amount of $23,547.

Environmental Protection Agency (EPA)

• Issue: A business owner expressed concern related to a pending enforcement action by the EPA regarding an inspection and an initial demand of a penalty in the amount of $515,869 for an alleged violation of the Clean Air Act. The business owner also expressed concerns regarding the agency’s notification of the final offer, and if parties were to be unable to reach an agreement, the potential to proceed to litigation.
• Outcome: With the Office of the National Ombudsman's involvement, the agency reached a settlement with the company.

Department of the Treasury

Internal Revenue Service (IRS)

• Issue: A tax services company was selected by the IRS for examination of the tax returns it prepared for others. The IRS found multiple counts of non-compliance, leading to an initial preparer penalty assessment of $54,570. The business owner appealed the proposed compliance review findings and the proposed penalty, and agreed to a reduced amount of due diligence penalties of $32,640. The IRS assessed the penalties and referred the case to IRS Collection. The business owner submitted an offer to settle the balance due for the amount that was potentially collectible from him.
• Outcome: Upon further review at the request of the Office of the National Ombudsman, with information provided by the business on their ability to pay, the IRS determined that the business did not have the ability to fully satisfy the penalty and accepted the business owner’s offer in compromise of $3,264.

Department of Defense (DOD)

Defense Health Agency (DHA)

• Issue: A health consulting company had a contract with DHA during the time when the company terminated two employees for substandard work. The contracting officer’s representative and Director met with the company and stated their dissatisfaction regarding the dismissal of the two employees. The Director provided the business with a recommended course of action, including elements that the company’s management did not believe were proper. Subsequently, the Director advised the business that the option for their contract would not be exercised and that the contract would be re-competed.
• Outcome: After the Ombudsman's intervention, the agency found that the health consulting company was performing successfully and providing excellent service under the support contract. The contracting officer’s representative and Director committed to taking corrective actions to prevent future conduct of this nature.

Department of Labor (DOL)

Occupational Safety and Health Administration (OSHA)

• Issue: A precast products manufacturer expressed concern regarding the impact of OSHA's new regulation 29CFR 1926.1400CC, Cranes and Derricks in Construction.
• Outcome: Upon completion of a high-level review, OSHA informed the Office of the National Ombudsman of its intent to consider rulemaking options to address the issue and announced a temporary enforcement policy pending the resolution of the rulemaking process.

Department of Health and Human Services (HHS)

Center for Medicare & Medicaid Services (CMS)

• Issue: A blood disease and cancer treatment center made several attempts to receive payments from a Medicare Advantage Organization; however, a processing system upgrade resulted in 113 incorrectly denied claims.
• Outcome: With assistance from the Office of the National Ombudsman, the healthcare provider recovered most of the claims, totaling approximately $170,800.

Small Business Administration (SBA)

• Issue: A small business owner requested assistance in resolving a falsified Economic Injury Disaster Loan (EIDL) application that was submitted, approved, and funded on their behalf.
• Outcome: Upon further review at the request of the Office of the National Ombudsman, SBA flagged the loan as alleged identity theft and initiated a thorough investigation into the matter. Because identity theft is a criminal offense requiring the agency to process a formal discharge through the lawful process, SBA informed the small business owner that they did not need to pay the monthly loan statements until the loan had been formally discharged.