Oversight Standards Research Articles

The Impact of COVID-19 on the Quality of Auditing from the Point of View of Jordanian Certified Public Accountants

The aim of this study is to investigate the impact of the COVID-19 pandemic on audit quality from the perspective of Jordanian Certified Public Accountants. It also aims to identify any differences in the views of Jordanian Certified Public Accountants regarding this impact based on respondents' demographic characteristics such as gender, academic qualification, scientific specialization, job title, years of experience in audit, and professional certifications. A quantitative approach was used in this study, where 150 questionnaires were distributed to 150 Jordanian certified public accountants, and 144 questionnaires were retrieved (27 of them were incomplete), resulting in 117 questionnaires being used for statistical analysis. The results of the study indicated that the COVID-19 pandemic had a significant impact on audit quality through the dimensions of audit fees, going concern assessment, audit procedures, auditor's experience, audit period, and audit firm size. The results also showed that there were differences in the views of Jordanian Certified Public Accountants regarding the impact of the COVID-19 pandemic on audit quality based on academic qualification, job title, and years of experience in auditing, while no differences were attributed to gender, scientific specialization, and professional certifications of the respondents. Based on the study's findings, the researcher provides several recommendations, including: Audit firms should prioritize the development of skills and experiences of their employees through alternative training programs and remote work arrangements. Audit firms should also review their audit processes and procedures to adapt to the new business environment created by the COVID-19 pandemic. Regulatory bodies should consider reviewing their oversight standards to address the exceptional challenges posed by the COVID-19 pandemic especially with regard to auditing and quality auditing.

State Oversight of Adult Residential Treatment for Behavioral Health Conditions

Research ObjectiveResidential treatment for mental and substance use disorders (M/SUDs) historically is not compensated by Medicaid due to the Institutions for Mental Disease payment exclusion. As the opioid epidemic has evolved, however, residential treatment is a more common setting for care. This study sought to identify the regulations and other policies regarding oversight of residential M/SUD treatment at the state level.Study DesignAfter conducting an environmental scan and interviewing experts, we developed a template to provide a coding structure for data collection. We gathered source data for all states and the District of Columbia by reviewing statutes and regulations governing behavioral health treatment or licensure. Detailed state summaries were prepared and shared with states for validation. State Medicaid regulations and waiver requirements related to residential treatment were also reviewed.Population StudiedResidential treatment was defined as clinical treatment services provided in a 24‐hour living environment. This definition eliminated programs such as group homes or recovery housing, unless regulations or state personnel indicated that clinical treatment must be provided by such facilities. We excluded facilities exclusively associated with the criminal justice system or located in inpatient settings.Principal FindingsResidential mental health treatment facilities are less likely to be regulated/licensed than are residential SUD treatment facilities. Most states require inspection at licensure, with somewhat fewer allowing for cause‐based inspections. Few state regulations include requirements for medical directors and more require the provision of “sufficient” staffing than incorporate ratios. Few incorporate explicit regulatory requirements for training staff in trauma‐informed care or suicide assessment/prevention. Specific requirements related to placement are most common in SUD residential treatment, reflecting the ASAM criteria. Few states mandate client follow‐up or aftercare to be provided by the residential facility postdischarge. Less than half of all state regulations regarding SUD residential treatment explicitly call for use of some type of evidence‐based treatment, with fewer for mental health treatment. Requirements related to medication‐assisted treatment are seldom expressly incorporated into residential treatment regulations. Thirty‐six and 48 states have promulgated some quality assurance regulations for residential mental health and SUD treatment, respectively.ConclusionsWhereas many states have some measure of oversight and licensure of residential treatment, specific criteria related to evidence‐based practices and quality are not included in many states. A complementary review of state oversight should be undertaken regarding residential settings that do not provide clinical treatment, such as recovery homes.Implications for Policy or PracticeOversight and licensure of residential treatment are complicated by the often‐bifurcated structure of state agencies, requirements specific to public funding, and nonregulatory approaches to oversight that can include contracting requirements, Medicaid waivers, and policy documents. Although licensure or oversight standards that are incorporated into laws and regulations may be the clearest mechanism for oversight, in some cases, it may not allow the flexibility required to operate within the states. Other mechanisms, such as state policy documents or requiring facility policies and procedures to address specific matters as part of licensure, may also achieve the same outcome with greater flexibilityPrimary Funding SourceASPE.

The impact of Sarbanes–Oxley on property-casualty insurer loss reserve estimates

The implementation of the Sarbanes–Oxley (SOX) Act in 2002 imposed a wide range of new oversight standards seeking to assure greater accuracy and transparency in the financial reporting of publicly traded firms in the U.S. This research assesses the relationship that the implementation of SOX shares with loss reserve estimation accuracy in the U.S. property-casualty insurance market. Using a comparative difference-in-difference approach, this research finds that, while publicly traded insurers have indeed experienced a significant reduction in loss reserve errors subsequent to SOX, the reduction is not attributable to SOX. These results hold true under a handful of robustness analyses.

Assessment of image quality and exposure parameters of an intraoral portable X-rays device.

To evaluate the exposure parameters, radiation protection, absorbed dose and radiographic image quality of the DIOX® intraoral portable radiography device. The exposure parameters were measured using the Xi UNFORS detector. Operator exposure to secondary radiation was measured using the 1800cc ionization chamber coupled to the electrometer. The absorbed dose (D) in the patient was calculated using TLD-100H positioned in the Alderson RANDO anthropomorphic simulator. The quality of the radiographic digital image was assessed by comparing radiographic images obtained from two conventional devices (CS 2200®, Carestream Health; Heliodent plus®, Sirona Dental Systems GMbH) with the radiological simulator of the upper molar region RMI (Radiation Measurements Instruments), using three acquisition sensors: Kodak RVG 5000® and Kodak PSP®, Eastman Kodak Company, Rochester, NY; EVO Micro Image®, Brazil. The DIOX intraoral portable radiographic device demonstrated reliability in relation to the performance of the standard evaluated parameters, except for the diameter of the radiation field (5.8 mm) less or greater. No evidence of device head radiation was detected. The Pb lead protection of the apparatus attenuates the secondary radiation, thus protecting the operator. However, it was observed that the region of the operator's gonads was the most exposed during the measurements. In the Alderson RANDO anthropomorphic simulator, the highest value of D was in the region corresponding to the submandibular and lingual glands of the left side (0.568 mGy). The image quality of the DIOX portable radiographic apparatus presented quality standards equivalent to those produced by the two conventional radiographic devices. The DIOX intraoral portable radiography device demonstrated reliability in relation to the quality control and radioprotection criteria, according to international standards. Results obtained demonstrated the safe use of the DIOX intraoral portable radiography device and indicated the need for debate and change in international sanitary oversight standards regarding the use of portable XR devices in dentistry.

Presenters or Patients? A Crucial Distinction in Individual Health Assessments.

Individual health assessments (IHAs) for asymptomatic individuals provide a challenge to traditional distinctions between patient care and non-medical practice. They may involve undue radiation exposure, lead to false positives, and involve high out-of-pocket costs for recipients. A recent paper (Journal of the American College of Radiology 13(12): 1447-1457.e1, 2016) has criticised the use of IHAs and argued that recipients should be classified as 'presenters', not 'patients', to distinguish it from regular medical care. I critique this classificatory move, on two grounds: one, it is conceptually suspect. Two, it obviates the medical ethics framework for IHAs, potentially exposing recipients of IHAs to lower standards of oversight and protection. Responsible regulation of IHAs will be easier to ethically justify if those seeking IHAs are considered patients and not merely presenters.

Delaware and Financial Risk

I argue that financial risk poses unique challenges that justify a differential application of corporate law oversight standards. The steps in my argument are as follows. First, I show how modern firms with significant exposure to financial risk are different in fundamental ways that matter crucially to the application of oversight standards. Second, I argue that, notwithstanding these differences, the major Delaware oversight cases were correctly decided, though the result might have been the opposite if complaints had been framed differently, with relevant and important facts. Third, I argue that the federal case involving the JPMorgan “London Whale” episode was wrongly decided. Unlike other scholars who have discussed director duties in the aftermath of the financial crisis, I am not arguing for any change in the oversight standards themselves. Instead, my argument is that Delaware law already provides ample support and justification for holding directors to a higher standard with respect to the oversight of financial risk. The complexities of financial risk pose unique challenges that the Delaware courts should take into account when assessing director oversight failures. Such an approach would not subject directors to unwarranted exposure for oversight failures, or have negative implications for business, and it would not change Delaware’s approach to cases that do not involve financial risk. The Delaware courts have demonstrated a capacity to respond to changes in the corporate contract, notably in Caremark itself, where Chancellor Allen recognized that the modern corporate practice of oversight had changed, and that the courts should change accordingly. Director oversight of financial risk is merely the most recent area in need of this kind of incremental judicial change. This chapter will appear in a forthcoming book, “The Corporate Contract in Changing Times,” co-edited by Professors Steven Davidoff Solomon and Randall Thomas.

Ontario pharmacists concerned about federal oversight of imported medications in light of birth-control pill recalls

Ontario pharmacists are among the Canadian health professionals publicly calling for more rigorous oversight of imported drugs, in light of 3 recalls of oral contraceptives across Canada since April 2013. More than 620,000 packages of 3 types of generic birth-control pills were recalled in Canada between April and September. These include Alysena from Apotex, and Freya-28 and Esme-28, both of which are manufactured in India for Mylan Pharmaceuticals in the United States. All the recalls were connected to problems with too many placebos in place of active-ingredient doses. The recalls have raised questions about the product integrity of some medications sold in Canada, said the Ontario Pharmacists Association (OPA) in a September 11 news release. The OPA urges Health Canada to increase scrutiny of brand and generic manufacturers for all aspects of drug production, including the packaging of finished products both in and outside of Canada. The Society of Obstetricians and Gynaecologists of Canada and the College of Family Physicians of Canada have also raised red flags about federal oversight of quality and safety in the manufacture and distribution of oral contraceptives and other medications. Pharmacists have a number of concerns with respect to the recalls, including some related to the recall process itself, said the OPA CEO, Dennis Darby, in an interview with CPJ. “There was no real notice,” he says. “Pharmacists found out at the same time as the media and public, so they didn’t have a chance to prepare. As the media reports were coming out, the OPA was getting calls from pharmacists asking what they should do.” Many pharmacists have been able to deal with the birth-control pills in question by taking an extra step for patients, Mr. Darby says. “Because one can see if the packages were prepared incorrectly, many pharmacists are opening up the packages in front of the patient to make sure all is fine. In this case, it was relatively easy for pharmacists to find out if there was a mistake—but that’s not always going to be the case for a recall.” It is critical for Health Canada to ensure the highest standards of oversight over pharmaceutical products imported into the country, he adds. “How do we make sure that we have a quality assurance system in place that can reassure Canadians?” —Dennis Darby, Chief Executive Officer, Ontario Pharmacists Association “As medications become more globally sourced, we ask the question—how do we make sure that we have a quality assurance system in place that can reassure Canadians and health care professionals that the products we are providing to patients meet the quality standards we expect?” Because these oversight issues are the responsibility of federal regulators, the OPA would like to work with the Canadian Pharmacists Association and other provincial pharmacist associations to address some of these areas of concern, says Mr. Darby.

The D&T Report

The D&T Report

Conforming with ICAO safety oversight standards

Air transportation is a highly safe mode of transportation. In part, this has come about as technological advances have improved aircraft, navigation systems, and air traffic control. There have also been significant advances in relevant ergonomics and in aircrew training and practices. Institutional changes have also played their part. The establishment of the International Civil Aviation Organization (ICAO) after the Second World War included a commitment of signatories to abide by common measures to ensure safety in International Air Transportation. The Organization, however, has limited powers of enforcement. The International Aviation Safety Assessment (IASA) program was initiated by the US to ensure that countries with services involving the US meet ICAO safety oversight standards. This paper makes use of the IASA assessment procedure to examine factors that influence whether countries are conforming to ICAO safety standards. It adopts a basic econometric framework of analysis to pursue the topic.