Federal Reports

The objectives of our audit were to determine (1) whether Federal Student Aid (FSA) ensured completion of corrective actions in response to audit and program review findings related to satisfactory academic progress (SAP), and (2) what actions FSA has taken to assist schools with compliance with SAP requirements.We found that FSA did not always ensure schools completed corrective actions related to the SAP findings identified in compliance audits and program reviews. This occurred because FSA’s Program Compliance office did not always perform the required resolution activities or address all SAP-related findings in the final determination letters. FSA’s failure to resolve SAP-related findings could result in (1) schools with repeated SAP findings, (2) ineligible students receiving Title IV program funds, (3) noncompliant schools continuing to participate in Title IV programs, or (4) FSA not establishing liabilities payable from schools that disbursed Title IV program funds to students who did not meet SAP requirements.

Our audit objective was to determine whether the Puerto Rico Department of Education (Puerto Rico DOE) has effectively designed internal controls for the administration of Immediate Aid to Restart School Operations (Restart) program funds. We found that the Puerto Rico DOE needs to enhance its system of internal controls to ensure that Restart program funds will be properly administered. Specifically, we foundthat the Puerto Rico DOE’s procurement and monitoring processes did not provide reasonable assurance that the Puerto Rico DOE will properly administer or adequately monitor Restart program funds. We found deficiencies in five of the six procurement transactions we reviewed.

Historically, only certain groups of individuals who had incomes and assets below certain thresholds were eligible for Medicaid (traditional coverage groups). After the passage of the Patient Protection and Affordable Care Act (ACA), some beneficiaries remained eligible under these traditional coverage groups. We refer to these beneficiaries as "non-newly eligible beneficiaries."

Prescription opioids continue to contribute to the opioid overdose epidemic. A prior OIG audit identified high volumes of opioid purchases in IHS communities. In addition, the prior OIG audit of two IHS hospitals determined that IHS did not have adequate information technology (IT) security controls to protect health information and patient safety. The audit also found significant differences in the way the two hospitals carried out their respective IT operations.

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This evaluation assessed the effectiveness and quality of the post's programming and training, Volunteer support, and leadership functions. Overall, we found that the post faced several challenges related to training Volunteers for working in their primary assignments, identifying and orienting community stakeholders for hosting and working with Volunteers, preparing for emergencies, supporting Volunteers who reported harassment and mental health challenges, and handling sensitive Volunteer information. This report included 16 recommendations for management's consideration.

The VA Office of Inspector General (OIG) conducted a healthcare inspection to determine the validity of confidential allegations that system leaders interfered with primary care providers’ opioid prescribing practices; requirements specified in Veterans Health Administration’s (VHA) Pain Management directive were not followed; and system leaders failed to meet all the goals of VHA’s Opioid Safety Initiative Update. The OIG substantiated that on four occasions the Chief of Staff interfered with primary care providers’ opioid prescribing practices. The OIG determined that patients did not have identifiable adverse clinical outcomes; however, the continuation of patients’ opioids may have prolonged their dependence on opioids. Providers also reported experiencing pressure by the Chief of Staff related to opioid prescribing practices. The OIG substantiated that the system did not follow all requirements in VHA Directive 2009-053, Pain Management. Further, not all providers used the required opioid risk assessment tools for patients on long-term opioid therapy. The OIG found that system leaders were not in compliance with the system’s policy related to veteran requests to change providers. The system met six out of nine goals outlined in VHA’s Opioid Safety Initiative Update. The OIG made one recommendation to the VISN 10 Director related to the ethics of a system leader interfering with the opioid prescribing practices of primary care providers and 11 recommendations to the System Director related to the Pain Management Committee, pain assessments, annual evaluation of compliance with the Pain Management Strategy, tertiary pain rehabilitation programs, stepped care education and training, the pain management team, opioid risk assessment tools, veteran requests to change providers, prescription drug monitoring program reports, and opioid and benzodiazepine tapering protocols.