Federal Reports

The VA Office of Inspector General (OIG) received wide-ranging allegations of misconduct in the operations of the Veterans Health Administration’s Consolidated Patient Account Center (CPAC) field offices, which function within the Office of Community Care and conduct medical billing functions for VA medical centers in designated regions. The OIG substantiated the following allegations: 1. CPAC management improperly used government funds to purchase food for CPAC employees in fiscal years 2015 and 2016 in connection with events held as part of VA’s Diversity and Inclusion initiative; 2. One CPAC violated VA policy for disposing of excess equipment when computer monitors were given to a local school without following established procedures; and 3. Some CPAC field offices violated VA policy requiring that destruction of temporary paper records be performed pursuant to a written contract. The OIG made two recommendations, with which VA concurred and took prompt corrective action. The OIG considers these recommendations closed. Allegations relating to improper travel, the misuse of funds for the purchase of daily planners and a wheelchair, and the improper use of purchase cards for armored car services were not substantiated.

The Federal Emergency Management Agency (FEMA) mismanaged the distribution of commodities in response to Hurricanes Irma and Maria in Puerto Rico. FEMA lost visibility of about 38 percent of its commodity shipments to Puerto Rico, worth an estimated $257 million. Commodities successfully delivered to Puerto Rico took an average of 69 days to reach their final destinations. Inadequate FEMA contractor oversight contributed to the lost visibility and delayed commodity shipments. FEMA did not use its Global Positioning System transponders to track commodity shipments, allowed the contractor to break inventory seals, and did not ensure documented proof of commodity deliveries. Given lost visibility and delayed shipments, FEMA cannot ensure it provided commodities to Puerto Rico disaster victims as needed to sustain life and alleviate suffering as part of its response and recovery mission. In addition, FEMA’s mismanagement of transportation contracts included multiple contracting violations and policy contraventions that ultimately led to contract overruns of about $179 million and at least $50 million of questioned costs. We made five recommendations that, if implemented, should improve FEMA’s management and oversight of its disaster response activities. FEMA concurred with four of the five recommendations. Recommendations 1 through 4 are considered open and resolved. Recommendation 5 is considered resolved and closed.

Previous Office of Inspector General (OIG) audits found that States had improperly paid Medicaid managed care entities capitation payments on behalf of deceased beneficiaries. We conducted a similar audit of the North Carolina Department of Health and Human Services, Division of Health Benefits, which administers the Medicaid program.Our objective was to determine whether North Carolina made capitation payments on behalf of deceased beneficiaries.