Federal Reports

Acting on a hotline complaint, the VA Office of Inspector General (OIG) reviewed whether a VA-contracted disability medical exam provider—Medical Support Los Angeles—had the capacity to complete scheduled exams, and whether Veterans Benefits Administration (VBA) staff were canceling and rescheduling them through other contractors. The OIG expanded the review to determine the adequacy of nationwide oversight of contracted disability exam cancellations. VA is authorized to contract disability exams from non-VA medical sources to increase its capacity and improve timeliness. The OIG examined the number of contracted disability exams requested and the number of exam cancellations from November 1, 2017, through April 30, 2018. During that period, claims processors requested more than 1.3 million disability benefits exams from contractors. In addition, more than 137,000 exams were canceled, an increase of about 74 percent over the previous six-months. These exams affected about 59,000 veterans. The OIG found that Medical Support Los Angeles failed to establish an adequate network of exam providers and, in December 2017, VBA began canceling exams scheduled with the contractor. More than 8,700 exams were rescheduled through other contractors by March 2018. Medical Support Los Angeles was also required to have nearly $4.8 million withheld from outstanding invoices to recoup costs associated with VBA obtaining alternate contractors to schedule and complete the exams. The OIG determined in its examination of contractors nationwide that additional oversight was needed to address information systems limitations, staffing shortages, and some VBA contracting officer’s representatives’ lack of required qualifications. The OIG recommended the Under Secretary of Benefits improve exam management systems to make cancellation information more accessible, provide sufficient Medical Disability Examination Program staff for oversight, and take steps to ensure contracting officer’s representatives with oversight responsibilities achieve the VA-required certification level.

We audited the multifamily Section 8 Project-Based Rental Assistance (PBRA) program at the Northline Point Apartments. We selected Northline Point in accordance with our goal to review the U.S. Department of Housing and Urban Development’s (HUD) multifamily housing programs and because of a request from HUD to audit the property based on extensive findings from its project-based contract administrator’s management and occupancy review. This is the fifth audit in a series of Office of Inspector General, Region 6, reviews of multifamily Section 8 PBRA programs. Our objective was to determine whether the owner administered its Section 8 PBRA program in accordance with applicable requirements.We found that the owner did not administer its Section 8 PBRA program in accordance with applicable requirements. Specifically, the owner billed HUD for at least 51 tenants whose eligibility it could not adequately support and subsidized uninspected units. These conditions occurred because the owner and its identity-of-interest management agent did not implement appropriate controls and lacked proper oversight of their staff, which allowed onsite managers to engage in questionable practices and mismanage the program. As a result, the owner received more than $1 million in housing assistance payments for tenants whose eligibility and unit physical condition standards it could not support. Further, the owner could not assure HUD that its certifications for reimbursement were based on accurate information, which could adversely affect the program.We recommend that the Southwest Region Director of Multifamily Housing require the Northline Point Apartments’ owner to (1) support or repay HUD more than $1 million for tenants whose eligibility the owner could not support; (2) perform annual inspections as required; and (3) implement appropriate controls to ensure that tenants are eligible, housing assistance subsidies are accurate, tenants are properly moved and transferred, transactions are properly coded, units are inspected as required, and tenant files contain all required documentation.

The All of Us Research Program (All of Us) is a major component of the Precision Medicine Initiative. All of Us is responsible for building a national research cohort of more than 1 million participants who will provide their personal health information to the National Institutes of Health (NIH) so researchers, providers, and patients can work together. Ensuring that participant data are securely maintained is paramount to retaining the participants' trust and participation in All of Us.