Federal Reports

The Veterans Health Administration’s (VHA) homemaker and home health aide program offers personal care and related services to help frail or disabled veterans with daily activities. The OIG examined whether veterans received intended program services and VHA accurately processed program claims.The team conducted this audit because of the large number of veterans in the program; its high cost; the risks experienced by older veterans, such as poor health and social isolation; and the volume and nature of hotline complaints about the program.The OIG found that VHA could not be certain that veterans received services from home health agencies that were licensed or certified, or met criteria for exemption, for about 546,000 of 1.1 million claims approved for payment between September 2018 and February 2019. Consequently, VHA may have made up to $145.4 million in improper payments.Medical facilities also applied program policies differently, or inconsistently prioritized veterans on the program’s waiting lists. The team also found variances in how some facility personnel addressed veterans who were difficult to place because of prior inappropriate behavior towards aides. These differences resulted in some facilities providing inconsistent access to services for some veterans and were partly caused by limited budget resources.VHA paid more than half of program claims within 30 days and nearly always accurately. However, it could further reduce risks of paying inadequately supported claims or claims for services not preauthorized. Based on a random sample of 200 program claims, the OIG estimated VHA improperly paid at least $8.5 million to home health agencies, with at least $5.5 million potentially recoverable.VHA concurred with the OIG’s eight recommendations on program policies and practices, controls for service agencies’ licensing and certification, program demand tracking, procedures for hard-to-place veterans, timeliness and claim payment monitoring, and a review of identified claim errors.

An Amtrak trackman based in Chicago, Illinois, was terminated from employment on November 23, 2020, following his administrative hearing. Our investigation found the former employee violated company policy when he failed to report an arrest and subsequent conviction for drug possession and a separate conviction related to unemployment fraud. The arrest and convictions occurred while the former trackman was employed by the company.

The October 2020 Semiannual Report to Congress summarizes the Office of Inspector General’s successful work completed from April 1, 2020, through September 30, 2020, to promote excellence, integrity, and accountability within the programs, operations, and management of the U.S. Department of the Interior. Our audit-related activities resulted in total monetary impacts of $18,416,069 with 83 recommendations made and 135 recommendations closed. Our investigative activities resulted in 4 indictments, 20 criminal and civil referrals, and $688,500 in civil settlements or recoveries.