Federal Reports

The VA Office of Inspector General (OIG) conducted this review to determine whether community care providers are receiving potential duplicate payments for the same healthcare services from VHA and Medicare and to determine whether VHA paid any of these claims without authorization. In this review, the VA OIG collaborated with the Department of Health and Human Services (HHS) OIG—which is currently conducting its own review of duplicate Medicare payments—to better understand duplicate payments and confirm that they had occurred. The VA OIG determined that VHA and Medicare made potential duplicate claim payments for community care services that were authorized by VHA. Because VHA and the Centers for Medicare and Medicaid Services do not share healthcare claims data, neither agency is aware of claims paid by the other agency. Without an interagency system, the risk of duplicate payments is increased, and it may be difficult to determine which agency should pay the claim and which agency can collect overpayments.The OIG made three recommendations to the under secretary for health, including working with the Centers for Medicare and Medicaid Services to establish a data-sharing agreement with VA to limit duplicate claim payments. The OIG also recommended identifying overpayments made for care provided to dual-eligible veterans that were not authorized by VHA and ensure documentation of care is completed or that VA seeks reimbursement for any unauthorized care. Finally, the OIG recommended making sure all nonemergent community care is preauthorized and that documentation for all authorizations is complete and properly stored before services are provided.

The VA Office of Inspector General (OIG) conducted this review to determine whether the Compensation Service complied with accessibility requirements for communicating benefits- related information to veterans with visual impairments. The OIG found that VBA’s Compensation Service did not fully comply with section 504 of the Rehabilitation Act. The review team determined that visually impaired veterans could be excluded from accommodations by the Compensation Service’s criteria, and even the legally blind veterans who meet the criteria are not accommodated through the entire claims process. Although VBA’s Adjudication Procedures Manual instructs claims processors to contact visually impaired veterans by telephone to discuss the contents of decision notices, 87 of 100 claims reviewed showed no documentation of processors making such calls. Consequently, some veterans may not have been made aware of adverse claims decisions or their rights to challenge such decisions.The OIG concluded that the Compensation Service’s continued failure to coordinate with relevant agencies, along with its failure to comply with VA-wide accessibility implementation requirements, will continue to make it more difficult for veterans with visual impairments to participate fully in the disability compensation program.The OIG made five recommendations to the under secretary for benefits: (1) update the process for developing, approving, and issuing guidance for accommodating visually impaired veterans to include steps for consulting with the Office of General Counsel; Office of Resolution Management, Diversity, and Inclusion; and previously, the Department of Justice Civil Rights Division; (2) update the adjudication procedures to comply with federal regulations and VA policies; (3) develop and implement a quality assurance mechanism to ensure compliance with accessibility requirements; (4) assign accessibility coordinators, publicize their names, and conduct a self-evaluation of policies outlined in VA accessibility requirements; and (5) coordinate a process to ensure visually impaired veterans are informed of the availability of accommodations.

Organizational Renewal: Semiannual Report to Congress for April 1, 2021 - September 30, 2021.

Semiannual Report to Congress, Volume 88 (April 1, 2022 - September 30, 2022)