Date Issued
|
Report Number
20-03210-83
|
Topics: Education and Loan Guaranty
All Reports
Date Issued
|
Report Number
20-00541-34
|
Topics: COVID-19
Date Issued
|
Report Number
19-06147-50
|
Topics: Supplies and Equipment
● Financial Management
Open
Closed-Implemented
Closed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 10/23/2024
Direct the Medical Supplies Program Office to implement procedures requiring chief logistics officers at Veterans Integrated Service Networks to monitor facility processes for verification and certification of distribution fee invoices to ensure invoice accuracy prior to payment by the Financial Services Center.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 2/11/2025
Require Veterans Integrated Service Network directors to ensure their chief logistics officers develop distribution fee monitoring and review procedures for facility logistics audits and compliance reviews to ensure invoices are adequately reviewed, verified, and certified.
No. 3
to Veterans Health Administration (VHA)
Closure Date: 7/31/2023
Require Veterans Integrated Service Network directors to ensure facility chief logistics officers and contracting officer’s representatives review and update the election forms according to contract requirements and provide copies to the Medical/Surgical Prime Vendors for acknowledgment.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 2/11/2025
Require Veterans Integrated Service Network directors to ensure facility contracting officer’s representatives verify that distribution fee rates match with those on the election forms and pricing schedule by comparing transaction data from the vendors to VHA-maintained transaction data, and reconcile payments as appropriate.
No. 5
to Acquisitions, Logistics, and Construction (OALC)
Closure Date: 3/25/2022
Require the Strategic Acquisition Center to develop and add modifications to the Medical/ Surgical Prime Vendor-Next Generation contract requiring prime vendors to provide reports to VA medical facilities with detailed medical and surgical transaction data, fee amounts, and fee percentage rates applied to each transaction on distribution fee invoices.
No. 6
to Acquisitions, Logistics, and Construction (OALC)
Closure Date: 3/25/2022
Require the Strategic Acquisition Center contracting officer to work with the Medical Supplies Program Office to ensure that Medical/Surgical Prime Vendor contracting officer’s representatives are assigned to each VA medical facility.
No. 7
to Acquisitions, Logistics, and Construction (OALC)
Closure Date: 5/2/2022
Require the Strategic Acquisition Center to appropriately modify the Medical/Surgical Prime Vendor contract to define annual facility purchase as well as adding a provision for paying the annual facility purchase amount based on the estimated total spend until year-end reconciliation.
No. 8
to Acquisitions, Logistics, and Construction (OALC)
Closure Date: 5/2/2022
Require the Strategic Acquisition Center to also appropriately modify the Medical/ Surgical Prime Vendor contract to require the prime vendors—rather than the facility—to reconcile to annual facility purchases at the end of the year.
No. 9
to Veterans Health Administration (VHA)
Closure Date: 7/31/2023
Require the Medical Supplies Program Office to establish policy that clearly defines the source VA medical facilities should use to estimate their annual facility purchase amounts and determine the year-end amounts.
No. 10
to Veterans Health Administration (VHA)
Closure Date: 9/3/2024
Require VA medical facilities to review their on-site representative fees paid during fiscal year 2018 and future years to ensure they were paid based on the actual annual facility purchase amounts, consistent with the Medical/Surgical Prime Vendor-Next Generation contract, and reconcile payment discrepancies as appropriate.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 3,700,000.00
Date Issued
|
Report Number
20-00421-63
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Benefits Administration (VBA)
Closure Date: 12/10/2024
The under secretary for benefits creates written guidelines for tracking, identifying, notifying, registering, and exempting individuals required to take skills certification tests.
No. 2
to Veterans Benefits Administration (VBA)
Closure Date: 12/10/2024
The under secretary for benefits establishes a tracking mechanism to ensure all eligible individuals required to take tests are identified and notified of testing dates at least 30 days prior to test administration.
No. 3
to Veterans Benefits Administration (VBA)
Closure Date: 9/25/2023
The under secretary for benefits provides an update to the plan submitted to Congress explaining why all employees and supervisors who have claims-processing functions listed in the original plan are not subject to skills certification testing.
No. 4
to Veterans Benefits Administration (VBA)
Closure Date: 12/10/2024
The under secretary for benefits implements a plan to ensure staff who failed their most recent skills certification test and remain in the same position are provided training from individual training plans to remediate the deficiencies in their skills and competencies.
No. 5
to Veterans Benefits Administration (VBA)
Closure Date: 12/10/2024
The under secretary for benefits establishes an oversight plan to ensure training set out in approved training plans is provided to individuals who fail skills certification tests.
No. 6
to Veterans Benefits Administration (VBA)
Closure Date: 12/5/2023
The under secretary for benefits notifies Congress of plans to take personnel actions against individuals who fail consecutive skills certification tests after remediation for the same positions in compliance with the Honoring America’s Veterans and Caring for Camp Lejeune Families Act of 2012.
Date Issued
|
Report Number
19-06902-23
|
Topics: Community Care
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 12/7/2021
The OIG recommended the under secretary for health ensures the Payment Operations and Management directorate reevaluates all sample claims identified in this audit as not processed in accordance with Office of Community Care guidance, and takes appropriate corrective action as needed.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 4/20/2022
The OIG recommended the under secretary for health ensures there is a contract requirement that the contractor’s employees must follow Office of Community Care guidance for processing non-VA care claims.
No. 3
to Veterans Health Administration (VHA)
Closure Date: 4/20/2022
The OIG recommended the under secretary for health ensures the contractor’s standard operating procedures for claims processing are accurate and a mechanism is put in place to keep the contractor’s procedures updated to reflect current Office of Community Care claims processing procedures.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 9/2/2021
The OIG recommended the under secretary for health ensures the Office of Community Care develops and implements clear controls for reviewing and updating, if necessary, the quality assurance surveillance plan requirements at least annually
No. 5
to Veterans Health Administration (VHA)
Closure Date: 9/2/2021
The OIG recommended the under secretary for health ensures the Payment Operations and Management personnel make full use of the established communication tracking tool.
No. 6
to Veterans Health Administration (VHA)
Closure Date: 3/2/2021
The OIG recommended the under secretary for health ensures the Payment Operations and Management leaders provide timely training and additional guidance to their staff and the contractor’s employees on applying and using standardized denial and rejection reasons, and employees follow procedures to process claims with no authorizations to ensure consistent and accurate claims processing.
Date Issued
|
Report Number
19-07053-51
|
Topics: Supplies and Equipment
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 11/29/2021
Provide clarifying guidance and controls to clinic staff on making determinations to send purchase requests and consult notifications to the appropriate purchasing agents.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 11/29/2021
Provide clarifying guidance to purchasing agents on how to effectively evaluate biologic implant purchase requests for the correct funding source.
No. 3
to Veterans Health Administration (VHA)
Closure Date: 11/29/2021
Provide clarifying guidance to prosthetic agents to ensure they receive clinic staff consult notifications on all prosthetic purchases of biologic implants.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 2/1/2022
Create a biologic implant cost code for general-purpose funds to improve funding accountability and potentially assist in ensuring all biologic implant use is tracked.
No. 5
to Veterans Health Administration (VHA)
Closure Date: 11/29/2021
Direct the Procurement and Logistics Office to clarify guidance on the use of an approved inventory management system specific to biologic implants and the related VHA network, office, and facility staff responsibilities.
No. 6
to Veterans Health Administration (VHA)
Monitor facility compliance with the use of an approved inventory management system for completeness and accuracy.
No. 7
to Veterans Health Administration (VHA)
Closure Date: 7/5/2023
Direct the Procurement and Logistics Office to ensure logistics staff perform inventory reviews of biologic implants, as required.
No. 8
to Veterans Health Administration (VHA)
Closure Date: 11/29/2021
Monitor medical facility compliance with required reviews of on-site inventory.
No. 9
to Veterans Health Administration (VHA)
Closure Date: 1/19/2024
Establish a structure for oversight responsibility that can provide guidance for tracking implanted biologics.
No. 10
to Veterans Health Administration (VHA)
Closure Date: 4/3/2024
Create policies and procedures for facilities to follow as they implement effective controls for tracking biologic implants.
No. 11
to Veterans Health Administration (VHA)
Establish standardized systems and requirements for facility staff to appropriately record necessary biologic implant attributes for accurate and accessible tracking of recipients to advance patient safety.
Date Issued
|
Report Number
20-02959-62
|
Topics: COVID-19
● Supplies and Equipment
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 9/2/2021
Provide specific guidance for personnel in facilities and Veterans Integrated Service Network offices to report expired personal protective equipment supplies into the Response Monitoring Tool and refine the tool to allow the entry of expired supply levels on hand.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 4/15/2022
Communicate effective verification measures for facilities and Veterans Integrated Service Networks to improve the reliability and consistency of reported personal protective equipment on-hand quantity and usage information.
Date Issued
|
Report Number
20-00295-61
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Benefits Administration (VBA),Veterans Health Administration (VHA)
Closure Date: 4/12/2021
The OIG recommended that the under secretary for benefits and the under secretary for health formalize interagency sharing processes between the Veterans Benefits Administration’s Denver regional office and the Veterans Health Administration’s Office of Community Care on how data and information will be shared between both offices to prevent payments from continuing to deceased spina bifida beneficiaries.
No. 2
to Veterans Benefits Administration (VBA),Veterans Health Administration (VHA)
Closure Date: 4/12/2021
The OIG recommended that the under secretary for benefits and the under secretary for health take the following actions establish clear written guidance on sharing beneficiary data between the Veterans Benefits Administration’s Denver regional office and the Veterans Health Administration’s Office of Community Care to ensure all entitled beneficiaries are enrolled in health care.
No. 3
to Veterans Benefits Administration (VBA)
Closure Date: 5/7/2021
The OIG recommended that the under secretary for benefits institute standardized procedures to help the Veterans Benefits Administration’s national call center agents provide accurate and comprehensive information about spina bifida benefits.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 9/14/2022
The OIG recommended that the under secretary for health direct the Veterans Health Administration’s Office of Community Care to develop a process to ensure those beneficiaries who are not using the services for which they are eligible, or need assistance with locating those services, receive them.
Date Issued
|
Report Number
18-00972-38
|
Topics: Patient Care Services Operations
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 11/5/2021
Ensure Prosthetic and Sensory Aids Service business practice guidelines include specific requirements for conducting and properly documenting reviews of cloned and pending consults.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 11/5/2021
Ensure Prosthetic and Sensory Aids Service staff develop a process to verify that consults include accessory and consumable supplies for prosthetic items prior to issuance.
No. 3
to Veterans Health Administration (VHA)
Closure Date: 11/5/2021
Ensure Prosthetic and Sensory Aids Service establishes field consistency requirements for conducting program reviews and evaluations.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 11/5/2021
Ensure the executive director of the Prosthetic and Sensory Aids Service complies with existing policy for reviewing program assessments and evaluations and communicates review and evaluation results to the regional prosthetic representatives.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 79,200,000.00
Date Issued
|
Report Number
20-02071-49
|
Topics: Claims and Fiduciary
Related Media: Video
Date Issued
|
Report Number
20-02339-35
|
Topics: Information Technology and Security
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Office of Enterprise Integration (OEI)
Closure Date: 7/6/2021
The acting assistant secretary for Enterprise Integration, in conjunction with the assistant secretary for Information and Technology, complies with requirement 3 in section 759(a) of the Geospatial Data Act to establish mandatory VA wide policies and responsibilities to promote the integration of geospatial data.
No. 2
to Information and Technology (OIT)
Closure Date: 5/9/2022
The assistant secretary for Information and Technology, in conjunction with the director of Enterprise Records Service, establishes a process to ensure geospatial data and activities are included on VA record schedules that have been approved by the National Archives and Records Administration in accordance with requirement 4 of the law.
Date Issued
|
Report Number
20-02774-26
|
Topics: COVID-19
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 5/12/2021
Issue guidance to medical facility staff on how the COVID 19 At Risk Veteran Report should be used to help service providers identify high risk veterans and educate those veterans on the need for extra precautions.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 1/4/2022
Ensure medical facility staff are monitoring and assisting with the service providers’ implementation of the Centers for Disease Control and Prevention guidance, including updates.
No. 3
to Veterans Health Administration (VHA)
Closure Date: 1/4/2022
Identify service providers that have not fully implemented the Centers for Disease Control and Prevention’s six feet social distancing guidelines, particularly for sleeping and meal areas, and encourage them to implement alternative measures or use VA options to help mitigate space limitations.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 1/4/2022
Monitor the availability of personal protective equipment at service providers’ residences, and help develop contingency plans in the event of a prolonged pandemic or surge.
Date Issued
|
Report Number
20-01408-19
|
Topics: Financial Management
Date Issued
|
Report Number
20-00608-29
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Benefits Administration (VBA)
Closure Date: 1/28/2022
Determine the actions needed to ensure staff understand evidence-gathering and verification of stressor requirements for posttraumatic stress disorder claims, and monitor the results to ensure effectiveness once those actions are implemented.
No. 2
to Veterans Benefits Administration (VBA)
Closure Date: 7/22/2021
Assess whether reorganizing or amending material in the Veterans Benefits Administration’s Manual M21-1, Adjudication Procedures Manual, related to the development of claims involving entitlement to service connection for posttraumatic stress disorder is needed for accurate processing.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 362,500,000.00
Date Issued
|
Report Number
19-09161-02
|
Topics: Appointment Scheduling and Wait Times
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 8/12/2022
The Under Secretary for Health has oversight controls developed and implemented to monitor all facilities’ patient care requests that are identified as “unable to schedule” to ensure patients across the Veterans Health Administration are scheduled in a timely manner.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 8/12/2022
The Under Secretary for Health ensures standard operating procedures are being implemented so that facility employees routinely review and act on patient care requests identified as “unable to schedule” in the consult toolbox.
No. 3
to Veterans Health Administration (VHA)
Closure Date: 11/29/2021
The Under Secretary for Health makes certain that facility leaders clearly define and oversee procedures on routinely reviewing, monitoring, and addressing transfer entries on the Light Electronic Administrative Framework.
Date Issued
|
Report Number
19-07316-262
|
Topics: Patient Care Services Operations
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 9/23/2022
The under secretary for health assess whether current program policies and practices meet the needs of medical facilities’ local homemaker and home health aide programs and update them as necessary.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 11/23/2020
The under secretary for health updates homemaker and home health aide program guidance to include processes that medical facilities must follow when assessing whether home health agencies are licensed or certified, meet specified conditions, or will be exempted from program requirements, to include determining a mechanism to track data on these decisions locally and nationally.
No. 3
to Veterans Health Administration (VHA)
Closure Date: 4/12/2022
The under secretary for health updates homemaker and home health aide program guidance to include procedures that medical facilities must follow to determine the suitability of veterans for program services when they cannot meet veterans’ program needs within the required period of time because of facility or community resource constraints.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 4/12/2022
The under secretary for health implements procedures for medical facility directors to use data on veteran demand, including unmet demand, for homemaker and home health aide program services to manage their local program resources.
No. 5
to Veterans Health Administration (VHA)
Closure Date: 9/23/2022
The under secretary for health updates homemaker and home health aide program guidance to include processes that medical facilities must complete when veterans with care needs have been refused services from home health agencies because of demonstrated behavioral issues.
No. 6
to Veterans Health Administration (VHA)
Closure Date: 5/14/2021
The under secretary for health reviews homemaker and home health aide program claims identified in the audit sample that involved improper payments made to home health agencies and recover funds if deemed necessary.
No. 7
to Veterans Health Administration (VHA)
Closure Date: 5/14/2021
The under secretary for health assesses the timeliness of homemaker and home health aide program claim payments and take corrective action as necessary.
No. 8
to Veterans Health Administration (VHA)
Closure Date: 5/14/2021
The under secretary for health makes sure there is sufficient monitoring of processed homemaker and home health aide program claims to mitigate the risk of paying claims not consistent with the corresponding authorizations.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 153,897,817.00
Date Issued
|
Report Number
20-02826-07
|
Topics: COVID-19
● Claims and Medical Exams
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Benefits Administration (VBA)
Closure Date: 10/6/2021
Further develop, implement, and test its strategy to reduce the exam inventory using in person, telehealth, and acceptable clinical evidence exams as safety and circumstances permit.
No. 2
to Veterans Benefits Administration (VBA)
Closure Date: 6/25/2021
Develop and implement a plan to increase the use of telehealth exams. VBA should also ensure contractors follow the Office of Disability and Medical Assessment telehealth guidance for exams that determine whether a telepresenter or specific medical equipment is required.
Date Issued
|
Report Number
18-04150-261
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 6/28/2021
The OIG recommends the VHA executive director for procurement ensures contracting officers are requesting preaward reviews for all sole source healthcare resource contracts with an annual value at or above $400,000 in keeping with the May 2018 revisions to VA Directive 1663.
No. 2
to Veterans Health Administration (VHA)
The OIG recommends the VHA executive director for procurement require an OIG preaward review for all interim contracts that exceed the $400,000 annual threshold.
No. 3
to Veterans Health Administration (VHA)
The OIG recommends the VHA executive director for procurement mandate an immediate postaward review for any sole source contract awarded on an interim basis as an emergency contract.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 4,101,555.00
Date Issued
|
Report Number
19-00226-245
|
Topics: Community Care
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Health Administration (VHA)
Closure Date: 8/5/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care Define the terms “verifiable usual and customary charges that are billed to payers other than VA” for the PC3/Choice contract claims.
No. 2
to Veterans Health Administration (VHA)
Closure Date: 8/5/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care ensure future community care programs have applicable definitions and guidance for claims without a Medicare or VA fee schedule rate to avoid reimbursements that pay at “billed charges.”
No. 3
to Veterans Health Administration (VHA)
Closure Date: 8/5/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care create a master usual and customary rate schedule to be used for reimbursement of community care claims without a Medicare or VA fee schedule rate to control program costs.
No. 4
to Veterans Health Administration (VHA)
Closure Date: 8/5/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care provide parties responsible for reimbursing PC3/Choice and future community care program claims with usual and customary rate price schedules and a formal written policy on the proper application of those rates.
No. 5
to Veterans Health Administration (VHA)
Closure Date: 8/5/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care establish controls for verifiable usual and customary rate payment methodology and establish a payment review process to ensure usual and customary rates are properly applied to the PC3/Choice and future community care program payments.
No. 6
to Veterans Health Administration (VHA)
Closure Date: 8/5/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care ensure payment-rate schedules used by the Plexis Claims Manager and future payment systems to support the PC3/Choice and future community care contracts are current, accurate, and complete to prevent overpayments.
No. 7
to Veterans Health Administration (VHA)
Closure Date: 9/28/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care ensure that the Office of Community Care determines an appropriate reimbursement process for the identified pass-through errors in this report.
No. 8
to Veterans Health Administration (VHA)
Closure Date: 9/28/2021
The OIG recommended the VA deputy under secretary for health for the Office of Community Care ensure the Office of Community Care establishes formal policies and procedures to identify and recover overpayments from PC3/Choice third-party administrators for improperly billed claims.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 205,100,000.00
Date Issued
|
Report Number
19-07062-255
OpenClosed-ImplementedClosed-Not ImplementedNo. 1
to Veterans Benefits Administration (VBA)
Closure Date: 11/19/2020
The under secretary for benefits directs the Compensation Service to provide the Administration Results Report for each consistency study to the Office of Field Operations and to managers at all regional offices.
No. 2
to Veterans Benefits Administration (VBA)
Closure Date: 5/5/2021
The under secretary for benefits ensures the Office of Field Operations develops a process to monitor regional offices to ensure maximum employee participation in consistency studies.
No. 3
to Veterans Benefits Administration (VBA)
Closure Date: 5/5/2021
The under secretary for benefits makes certain the Office of Field Operations establishes a requirement for regional office managers to review consistency study results and develop a plan for corrective action based on the performance of their regional office.
No. 4
to Veterans Benefits Administration (VBA)
Closure Date: 5/5/2021
The under secretary for benefits requires the Office of Field Operations to develop a follow-up process to confirm all corrective actions identified are completed by regional office managers.