Federal Reports

This Office of Inspector General (OIG) Comprehensive Healthcare Inspection Program report provides a focused evaluation of the quality of care delivered in the inpatient and outpatient settings of the Dayton VA Medical Center and multiple outpatient clinics in Ohio and Indiana. The inspection covers key clinical and administrative processes that are associated with promoting quality care. This inspection focused on Leadership and Organizational Risks; COVID-19 Pandemic Readiness and Response; Quality, Safety, and Value; Medical Staff Privileging; Medication Management: Long-Term Opioid Therapy for Pain; Mental Health: Suicide Prevention Program; Care Coordination: Life-Sustaining Treatment Decisions; Women’s Health: Comprehensive Care; and High-Risk Processes: Reusable Medical Equipment.The executive leadership team had worked together for five weeks at the time of the OIG’s inspection. The team faced multiple challenges, including responding to the COVID-19 pandemic and beginning the electronic health record modernization. Although leaders have opportunities to improve veteran experiences, most survey results for women veterans were generally better than those for female patients nationally. Review of accreditation findings, sentinel events, and disclosures did not identify any substantial risks, although the OIG noted a repeat finding from the previous comprehensive healthcare inspection visit related to completion of all required focused professional practice elements. Leaders were able to speak knowledgeably about selected data used in Strategic Analytics for Improvement and Learning models and actions taken to maintain or improve performance.The OIG issued 10 recommendations for improvement in five areas:(1) Medical Staff Privileging• Professional practice evaluations• Provider exit reviews(2) Medication Management• Committee oversight(3) Mental Health• Follow-up visits• Patient safety plans(4) Care Coordination• Treatment plan referral and review(5) Women’s Health• Collateral duties

EAC OIG, through the independent public accounting firm of McBride, Lock & Associates, audited West Virginia's use of Help America Vote Act funds for the period June 29, 2018, through September 30, 2019.

OIG data analytics identified Washington, D.C., MOW permit postage refunds totaling about $978,640 for fiscal year (FY) 2020, which is 98 percent of the district total and the highest in the nation. The office issued more BRM refunds compared to other post offices because companies located in other states purchased their BRM permits with a Washington, D.C., address. The refund total for this account is 46 percent of the unit’s year-end total revenue of about $2 million for Washington, D.C. MOW. In addition, we identified several months with little or no refund activity. The objective of this audit was to determine whether postage affixed BRM refunds were properly issued, supported, and processed at the Washington, D.C., MOW.

The Postal Service is required to maintain a safe and healthy environment for both employees and customers in accordance with its internal policies and procedures and Occupational Safety and Health Administration (OSHA) safety laws. Our objective was to determine if Postal Service management is adhering to building maintenance, security and safety standards, and employee working condition requirements at post offices.

Since the beginning of the COVID-19 pandemic, the federal government has appropriated over $3.5 trillion to address the public health and economic crises. Given the changing nature of the pandemic and the federal government’s response, we re-visited our original top management challenges to ensure that the PRAC is providing timely information to Congress and the new Administration about the response efforts. The following four challenges have been added: Preventing and Detecting Fraud against Government Programs; Informing and Protecting the Public from Pandemic-Related Fraud; Data Transparency and Completeness; and Federal Workforce SafetyProject Type: Management Challenges

A previous Office of Inspector General (OIG) audit found that a State Medicaid agency had improperly paid capitation payments on behalf of beneficiaries with concurrent eligibility in another State. We conducted a similar audit of Illinois' Medicaid program.Our objective was to determine whether Illinois made capitation payments on behalf of Medicaid beneficiaries who were residing and enrolled in Medicaid in another State.