Federal Reports

Congress enacted the Comprehensive Addiction and Recovery Act (CARA) of 2016 to improve opioid therapy and pain management for veterans. Within CARA, the Jason Simcakoski Memorial and Promise Act (Jason’s Law) requires each Veterans Health Administration (VHA) medical facility to have a pain management team (PMT) to coordinate and oversee pain management therapy. The Pain Management, Opioid Safety, and Prescription Drug Monitoring Program (PMOP) was established in part to ensure the requirements of CARA and Jason’s Law are met.

In fiscal years (FY) 2022 through 2024, the PMOP received $647 million in specific purpose funds to support pain management and opioid safety programs primarily at the medical-facility level. However, the PMOP returned about $126.7 million unused in FYs 2022 and 2023. The VA Office of Inspector General (OIG) conducted this audit to evaluate the PMOP’s management of specific purpose funds.

The OIG found the PMOP did not always effectively communicate with VISNs and medical centers so that they could plan for efficient use of funds. In addition, the program did not always communicate important funding information with key officials before allocating funding. Finally, VHA and the PMOP need to strengthen oversight to ensure fully compliant PMTs are in place at each VHA facility.

The OIG made five recommendations to the under secretary for health. The OIG agreed to close two; VHA has already taken sufficient action related to instructing the PMOP to communicate pertinent funding information with key staff before the start of the next fiscal year. VHA also agreed to ensure the program clarifies and defines PMT requirements and establishes a way to periodically validate PMT information and to require the program and the chief operating officer to address each medical facility’s lack of progress in achieving a PMT.

Why We Did This Report

The U.S. Environmental Protection Agency Office of Inspector General conducted this audit to determine whether the EPA complied with the Payment Integrity Information Act for fiscal year 2024 reporting and to review the EPA’s implementation of its corrective action plans for prior audit recommendations.

Summary of Findings

The EPA did not comply with applicable Office of Management and Budget requirements for the Payment Integrity Information Act of 2019 for its fiscal year 2024 reporting. Specifically, for its grants payment stream, the EPA published a 0.77 percent improper payment estimate with no unknown payments. The Agency’s estimate was not based on an accurate sampling and estimation methodology plan, referred to as a statistical sampling plan. Therefore, we could not determine whether the published estimate is valid and representative of the grant program characteristics. In addition, the EPA needs to improve its documentation to ensure compliance with policies and procedures. The Office of the Chief Financial Officer does not require staff to document who performed the risk assessment review and what information staff considers in the qualitative risk assessment reviews.

We found that the Agency completed corrective actions for the three recommendations from our FY 2023 audit report and for one recommendation from our FY 2021 audit report.

Why We Did This Report

The U.S. Environmental Protection Agency Office of Inspector General performed this audit to determine whether the U.S. Chemical Safety and Hazard Investigation Board, known as the CSB, complied with the Payment Integrity Information Act of 2019 in fiscal year 2024.

Summary of Findings

In FY 2024, the CSB complied with PIIA and OMB improper payment requirements. The outlays for the CSB totaled $11.34 million. The CSB reported gross improper payments totaling $2,659. These improper payments were associated with payroll and travel expenses. The CSB reported no unknown payments, resulting in a total improper and unknown payment of $2,659, or 0.02 percent of total outlays. This total was significantly less than the statutory threshold of 1.5 percent of program outlays established in PIIA for improper and unknown payments. In addition, we confirmed that the CSB complied PIIA reporting requirements to (1) publish payment integrity information with the Agency’s annual financial statement and accompanying materials and (2) post the annual financial statement and accompanying materials on its website.

The VA Office of Inspector General (OIG) Vet Center Inspection Program provides a focused evaluation of aspects of the quality of care delivered at vet centers. This inspection report evaluated four randomly selected vet centers throughout Midwest district 3 zone 2: Evanston, Illinois; Gary Area, Indiana; and La Crosse and Milwaukee, Wisconsin.

This OIG inspection focused on four review areas: suicide prevention; consultation, supervision, and training; outreach; and environment of care. The suicide prevention review evaluated vet center staff participation on VA medical facility mental health executive councils, resulting in one recommendation across three of the four vet centers inspected. The consultation, supervision, and training review identified concerns with external clinical consultation, monthly client record reviews, and completion of select trainings, resulting in three recommendations across all four vet centers inspected. The outreach review evaluated outreach plan completion, inclusion of strategic components, and tailoring of outreach activities to eligible individuals, which resulted in one recommendation across three of the four vet centers inspected. The environment of care review evaluated vet centers’ physical environment and general safety, resulting in one recommendation at one of the three vet centers inspected. One vet center was closed and had a temporary location; therefore, an environment of care review was not completed at this site. However, the inspection did result in additional findings related to the vet center’s closure and relocation, resulting in two recommendations.

The OIG issued a total of eight recommendations for improvement.

The objective of our audit was to determine whether the U.S. Department of Education (Department) complied with the Payment Integrity Information Act of 2019 (PIIA) for FY 2024. We found that the Department complied with the PIIA for the FY 2024 reporting period because it met all six compliance requirements as described in Finding 1. However, we found that the Department could improve its processes for implementing its methodologies for estimating improper payments and unknown payments. While we found that the point estimates for the Federal Pell Grant (Pell) and William D. Ford Federal Direct Loan (Direct Loan) programs reflect the programs' annual improper payments and unknown payments, we found that the Department’s improper payment and unknown payment estimates for these programs were not reliable because of issues in the calculation of the confidence intervals, as described in Finding 2. Specifically, the improper payment sampling and estimation plans for the Pell and Direct Loan programs included nonrandom student-level sampling from some of the compliance audits Federal Student Aid (FSA) used to calculate the estimates, which affected the accuracy and appropriateness of the confidence intervals used in the calculation of the improper payment and unknown payment estimates. The nonrandom student-level sampling issue has been a repeat finding since our report on the Department’s compliance with improper payment reporting requirements for FY 2019. We recommend that FSA develop sampling and estimation plans for the Pell and Direct Loan programs that will produce reliable estimates. 

The Payment Integrity Information Act (PIIA) requires agencies to annually review and identify programs and activities that may be susceptible to significant improper payments, estimate the improper payment rates in agency programs, and report on their actions to reduce and recover those payments. For FY 2024, AmeriCorps met eight of ten PIIA compliance requirements. We made three findings relating to the two remaining requirements.  We found that: (1) AmeriCorps reported an improper payment rate above the ten percent compliance threshold for one program, the Foster Grandparent Program (FGP); (2) AmeriCorps’ published improper payment estimates for AmeriCorps State and National (ASN) and FGP are not accurate, reliable, or consistent with OMB guidance; and (3) AmeriCorps’ published improper payment estimates for the National Service Trust (NST) are not accurate, reliable, or consistent with OMB guidance. AmeriCorps concurred with the first finding and agreed to continue to develop and implement actions to reduce improper payment rates below ten percent. AmeriCorps did not concur with our second and third findings. We made six new recommendations related to our second and third findings in this report on unmatched reporting errors, payments to ineligible recipients, and published improper payment estimates for the NST. AmeriCorps declined to implement all six recommendations. We will keep open the two prior year recommendations related to the first finding until AmeriCorps submits documentation to demonstrate the completion and sufficiency of the corrective actions. The six recommendations related to the second and third findings will remain open and be classified as unresolved (disagreed) in our Semiannual Report to Congress.