Federal Reports

This document discusses EAC OIG's planned oversight activities for fiscal year 2026.

The VA Office of Inspector General (OIG) reviewed aspects of community care utilization at the VA Boston Healthcare System for fiscal year 2024. The system, part of Veterans Integrated Service Network 1, includes three VA medical centers and several outpatient clinics. VA direct care (provided at VA facilities) and VA community care (delivered by providers in the community paid by VA) were compared.

The patient population consists of 58,324 patients who received medical care at the system or through community care paid for by the system. Nearly all received primary and mental health care through VA direct care. About 97 percent of patients received specialty care services exclusively through VA direct care. Inpatient community care accounted for 12 percent of acute care bed-days. Most community care referrals were requested due to drive times.

The OIG assessed referral processes, appointment timeliness, and use of disqualified providers for community care services. About 83 percent of direct and 84 percent of community care referrals were activated within two days. Appointment setting met timeliness standards in 55 percent of direct and 53 percent of community care referrals. Over 90 percent of referrals were completed within 90 days of the requested date. However, some referrals lacked documentation of scheduled appointments.

The OIG found no community care referrals for primary care and less than 3 percent for mental health care. About 66 percent of mental health and 61 percent of specialty care community appointments met timeliness standards. No disqualified providers were found. 

In response to three recommendations, the System Director concurred with two recommendations and described enhancing reports of metrics for scheduling, completed appointments, wait times, and facility access and identifying opportunities to improve and refine practices. The System Director concurred in principle with one recommendation and committed to educating staff on consult documentation practices.

In keeping with its responsibilities under the Inspector General Act of 1978, as amended, the OIG monitored the audit of TVA's fiscal year 2025 financial statements performed by Ernst and Young LLP (EY) to assure their work complied with Government Auditing Standards. Our review of EY's work disclosed no instance in which the firm did not comply in all material respects with Government Auditing Standards.

We contracted with the independent public accounting firm RMA Associates, LLC (RMA) to audit the consolidated financial statements of the United States International Development Finance Corporation (DFC) for the fiscal year ended September 30, 2025, report on internal control over financial reporting, and report on compliance with laws and other matters. The contract required the audit to be performed in accordance with U.S. generally accepted auditing standards, Office of Management and Budget audit guidance, and the Government Accountability Office’s and Council of the Inspectors General on Integrity and Efficiency’s Financial Audit Manual. 

In its audit of DFC, RMA reported 

• the consolidated financial statements were fairly presented, in all material respects, in accordance with U.S. generally accepted accounting principles;

• no material weaknesses1 and no significant deficiencies2 in internal control over financial reporting; and 

• no reportable noncompliance with provisions of laws tested and other matters. 

RMA is responsible for the attached auditor’s report dated November 14, 2025 and the conclusions expressed therein. We do not express opinions on DFC’s consolidated financial statements, or report on internal control over financial reporting, or report on compliance and other matters.