Federal Reports

The VA Office of Inspector General (OIG) conducted a healthcare inspection to review allegations of a delay in diagnosis of a patient’s prostate cancer and lung cancer at the Central Texas VA Health Care System (facility) in Temple, Texas.The OIG substantiated a delay in the diagnosis of the patient’s prostate cancer, identified concerns with the quality of care provided by two nurse practitioners in the urology clinic, and found facility leaders failed to ensure the competency of nurse practitioners to practice independently. The OIG was unable to substantiate a delay in the patient’s lung cancer diagnosis. However, the OIG identified a related concern regarding leaders’ failure to communicate expectations that providers offer patients low-dose computed tomography (CT) scans in the community for lung cancer screening.Two nurse practitioners failed to offer the patient a prostate biopsy despite elevated prostate-specific antigen levels and an abnormal prostate exam. Additionally, facility leaders did not complete required focused professional practice evaluations when the nurse practitioners were granted independent privileges and ongoing professional practice evaluations did not include any urology-specific indicators. Finally, although facility leaders informed providers about low-dose CT for lung cancer screening, the communication lacked clear expectations and direction for which patients should be screened.The OIG made four recommendations to the Facility Director: (1) to review the care both nurse practitioners provided to the patient, (2) to review the care both nurse practitioners provided to other urology patients, (3) to review the privileging and professional practice evaluation processes and performance indicators for nurse practitioners granted full practice authority in specialty care clinics, (4) and to ensure that facility leaders communicate expectations related to low-dose CT to facility primary care providers.

The Office of Inspector General performed an inspection of the Forest Se1vice to determine the likely level of sophistication an attacker would need to compromise selected USDA systems or data.

The fiscal year 2024 investigative priorities address the most significant challenges related to the programs and operations of the EPA and the CSB.

The Fiscal Year 2024 Oversight Plan describes our planned and ongoing oversight projects. The plan reflects the priority work that the OIG believes is necessary to keep the EPA, the CSB, and Congress fully informed about issues related to the administration of Agency programs and operations.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements.