Federal Reports

The VA Office of Inspector General (OIG) conducted a healthcare inspection related to community care coordination delays for a patient with oral cancer at the Veterans Health Care System of the Ozarks (facility) in Fayetteville, Arkansas.The OIG determined that the facility’s Office of Community Care (OCC) staff failed to schedule radical resection surgery within 30 days of an initial consult and failed to act or delayed taking action on five community care consults for the patient’s surgery. As a result, the patient’s surgery took place 205 days after the first consult was placed. Facility OCC staff could not provide an explanation for the failure to act or the delays.The OIG substantiated that facility OCC staff failed to coordinate radiation therapy and delayed coordinating chemotherapy to begin within six weeks after surgery, as requested. Community hospital staff did not use a request-for-services form when seeking approval for the patient’s radiation therapy and chemotherapy evaluation appointment. Facility OCC staff denied the referral for radiation therapy at the community hospital, citing a lack of Veterans Health Administration OCC guidance on community care referrals. Although facility OCC staff entered a consult for chemotherapy at the facility, they failed to communicate the urgency of the care to facility oncology providers.A facility oncology provider saw the patient nine weeks after surgery and documented changes to the patient’s oral cancer and that radiation therapy would not be beneficial. The patient was placed on palliative care and died.The OIG made one recommendation to the Under Secretary for Health related to standardizing community care coordination for follow-up requests from the community provider and two recommendations to the Facility Director related to completing consults within the 30 days and coordinating oncology care in the community.

Objective: To determine whether the Social Security Administration’s (SSA) Information Technology Investment Process (ITIP) supports strategic decision making and allows the Agency to plan for, manage, and implement information technology (IT) investments as projected.

DHS’ IT systems did not effectively allow CBP and ICE personnel to track migrants from apprehension to release or transfer. Instead, DHS personnel and partner agencies at the border implemented manual and ad hoc workarounds to process migrants apprehended illegally entering the United States. DHS personnel also faced challenges when data was not consistently documented in DHS’ systems of record. For example, migrant apprehension times were not recorded in a consistent manner, and we identified missing migrant data that prevented DHS from determining family status. Also, CBP did not always document a migrant’s intended U.S. address before releasing the individual into the United States using prosecutorial discretion to await immigration proceedings. We made eight recommendations that will help prioritize funding needs and make integration improvements to DHS IT systems to promote timely and accurate information sharing within DHS and with external partners. The Department concurred with all recommendations.

Background: We conducted this review to determine the extent to which the data files the Social Security Administration (SSA) provided the Internal Revenue Service (IRS) to facilitate economic impact payments (EIP) under the American Rescue Plan Act of 2021 (ARPA) were accurate and complete when they were transmitted.ARPA became law on March 11, 2021 and authorized a third round of IRS-administered EIPs (EIP3). To assist in identifying Old-age, Survivors and Disability Insurance (OASDI) beneficiaries and Supplemental Security Income (SSI) recipients potentially eligible for EIP3s, the IRS requested SSA provide beneficiary and recipient data.On March 25, 2021, SSA completed delivery of OASDI and SSI production data that provided IRS with information on approximately 72 million beneficiaries and recipients.