As required by the standards, we tested selected transactions and records to obtain reasonable assurance about the USMS's compliance with laws and regulations that, if not complied with, we believe could have a material effect on operations. Compliance with laws and regulations applicable to prisoner medical care is the responsibility of USMS management.

An audit includes examining, on a test basis, evidence about laws and regulation. The specific requirements for which we conducted tests are contained in the Unites States Code, Title 18, §4013, §4006, and Public Law 106-113.

We found that the USMS was not in full compliance with Section 4006, as amended by Public Law 106-113, which authorizes the USMS to pay for health care provided to federal prisoners at the lesser of the Medicare or Medicaid rates for said health care services (See Finding 3).

Except for the abovementioned issue and other issues discussed in the Finding and Recommendations sections of this report, nothing came to our attention that causes us to believe that USMS management was not in compliance with the sections of the United States Code cited above.