Federal Reports

The VA Office of Inspector General (OIG) conducted this audit to determine whether community care providers associated with the Fayetteville, North Carolina, VA Medical Center (VAMC) stopped accepting Non-VA Care (NVC) and Veterans Choice Program (Choice) authorizations. In July 2017, the OIG received an allegation that two orthopedic community providers stopped accepting VA patients because claims were not paid timely. The OIG substantiated the allegation and determined that at least 15 community providers stopped accepting VA patients from January 2015 through July 2017 primarily because claims were not being paid timely and there was difficulty resolving unpaid claims. The VA’s Office of Community Care is responsible for paying NVC claims. The network’s third-party administrator, Health Net, is responsible for paying Choice claims. The OIG determined community providers who stopped accepting NVC authorizations waited, on average, about 46 days for their claims to be processed in 2017. The OIG also found provider frustration over unpaid Choice claims stemming from Health Net’s clearinghouse automatically rejecting some claims and not notifying providers. Fewer community providers affected the ability to schedule patients for dermatology, neurosurgery, orthopedic, and urology services in the community. Also, VA paid about $156,000 in interest on delayed payments. If there is no improvement in the timeliness of payments, and if VA staff do not effectively address community provider medical claim inquires, additional providers may stop accepting VA patients, presenting a risk of increased wait times and travel distances. The OIG made six recommendations including ensuring community care provider participation is monitored at the local level, dedicating staff needed to process medical claims, ensuring staff are not inaccurately rejecting claims and notifying providers when claims are rejected, implementing controls to ensure the timely resolution of medical claim inquiries, and overseeing procedures to ensure the resolution of medical claim inquiries.

We determined that U.S. Immigration and Customs Enforcement (ICE) did not analyze program needs to determine how many additional 287(g) program managers should be hired and was not able to hire enough to keep up with the quick expansion. In addition, a lack of information technology (IT) support staff and a lengthy installation process have hampered prompt delivery and installation of IT equipment that law enforcement agencies in the 287(g) program need to carry out their immigration enforcement-related duties. Finally, ICE may not be training law enforcement officers efficiently and is not monitoring the officers to ensure they complete required training. We recommended that ICE address issues with 287(g) program staffing, improve the timeliness of IT equipment delivery to law enforcement agencies, and assess program participant training. We made four recommendations that will help improve program management and oversight. ICE concurred with three of four recommendations.

In 2017, U.S. Customs and Border Protection (CBP) made considerable progress developing and implementing a biometric capability to track air passenger exits using facial recognition technology. CBP’s Biometric Entry-Exit Program conducted a pilot at nine airports and demonstrated ability using this technology to match 98 percent of passengers’ identities at departure gates. However, During the pilot, CBP encountered various technical and operational challenges that limited biometric confirmation to only 85 percent of all passengers processed. These challenges included poor network availability, a lack of dedicated staff, and compressed boarding times due to flight delays. Further, due to missing or poor quality digital images, CBP could not consistently match individuals of certain age groups or nationalities.

The OIG used data analytics to identify offices with potentially fraudulent Voyager card activity. The analytics identified Centerville Branch had 22 transactions totaling $2,395 at risk during May 2018. The unit had 691 Voyager card transactions totaling $19,090 for all of May 2018. The objective of this audit was to determine whether Voyager card transactions were properly reconciled for detecting and disputing potentially fraudulent activity at the Centerville Branch, Snellville, GA.