Federal Reports

Objective: To determine whether the Social Security Administration’s eligibility and payment determinations for Supplemental Security Income recipients who owned trusts were accurate.

This Office of Inspector General Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the inpatient and outpatient care provided at the Michael E. DeBakey VA Medical Center in Houston and multiple outpatient clinics in Texas. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (emergency department and urgent care center suicide prevention initiatives)The OIG issued three recommendations for improvement in three areas:1. Leadership and Organizational Risks• Institutional disclosures for sentinel events2. Medical Staff Privileging• Ongoing Professional Practice Evaluations by providers with equivalent training and similar privileges3. Environment of Care• Furnishings and equipment safe and in good repair

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report highlights the results of a focused evaluation of Veterans Health Administration (VHA) facilities’ medication management related to teratogenic medication prescriptions. The report describes a finding from healthcare inspections performed at 45 VHA medical facilities. The OIG interviewed key staff and reviewed the electronic health records of 1,352 randomly selected patients with the potential to become pregnant, who received care at the inspected facilities from July 1, 2020, through June 30, 2021, and were prescribed a teratogenic medication.The OIG issued one recommendation for improvement related to providing counseling to patients who have the potential to become pregnant on the risks and benefits of teratogenic medications prior to prescribing them and documenting the counseling in the electronic health record.

The objective of our audit was to evaluate acquisition planning and the internal controls over the contracting practices for the procurement of goods and services under contracts issued by the PRC. Our audit determined whether controls implemented in response to past audits were effective. We reviewed 36 contract files totaling $2,619,329, which included 13 acquisitions using PRC-drafted contracts and 23 purchase orders issued between October 1, 2019, and September 30, 2022.

Once a major system is fully deployed, it transitions to the sustainment phase, where Office of Management and Budget Circular No. A-11 provides guidance to Federal agencies to conduct an operational analysis (OA) periodically to ensure systems continue to perform as intended. From fiscal years 2018 through 2021, the Department of Homeland Security had 15 major systems that transitioned to sustainment and required OAs; these systems had operations and maintenance costs totaling about $1.1 billion in FY 2021.

In November 2021, Congress passed the VA Transparency & Trust Act of 2021 (Transparency Act) to provide oversight of VA’s spending of COVID-19-related emergency relief funding, including funding related to the Families First Coronavirus Response Act (FFCRA) and the Coronavirus Aid, Relief, and Economic Security (CARES) Act. To comply, VA must provide a detailed plan to Congress outlining its intent and justification for obligating and expending funds covered by the act. Additionally, the Transparency Act requires VA to submit biweekly reports to Congress detailing its obligations, expenditures, and planned uses, as well as justification for any deviation from the plan. The act also requires the VA Office of Inspector General (OIG) to submit semiannual reports comparing how VA is obligating and expending covered funds to the planned obligations and expenditures. In this fourth report, the OIG found VA initially purchased services, supplies, and materials that were not aligned with FFCRA but took action to correct its obligations and expenditures based on guidance from the Office of General Counsel. The OIG determined that expenditure transfers may pose a risk to VA’s financial reporting and that VA generally did not comply with its financial policies to process and authorize FFCRA expenditure transfers. The OIG also found that VA generally complied with the Transparency Act for CARES Act reporting requirements and biweekly reports. The OIG made one recommendation to VA’s under secretary for health to ensure that Veterans Health Administration fiscal staff are trained on the VA financial policy requirements for the preparation and approval of journal vouchers (including expenditure transfers).

We inspected the U.S. Small Business Administration’s (SBA) corrective action(s) for 8 of our 11 recommendations from the Office of Inspector General (OIG) audit report Audit of SBA’s Oversight of the SCORE Association to determine whether SBA continues to practice corrective actions. A verification inspection is a limited scope that focuses on closed recommendations from prior OIG reports.We determined OIG Report 19-12 recommendations 1, 2, 5, 6, 7, 8, and 11 to be fully implemented; however, SBA program officials did not fully implement recommendation 10. We will track management’s implementation by reopening the recommendation and will work with SBA to establish a target date for implementing corrective actions through the audit follow-up process.