Federal Reports

The VA Office of Inspector General (OIG) conducted this audit to determine whether the Office of Information and Technology and the Veterans Health Administration (VHA) effectively managed the implementation of VA’s Veterans Information Systems and Technology Architecture (VistA) Scheduling Enhancement (VSE) project. VA has struggled for almost two decades to replace its cumbersome and outdated medical appointment scheduling system. VSE was launched in May 2014 and was intended to be an interim solution to VA’s medical appointment scheduling problem. The OIG found the VSE project management team did not effectively manage the project to ensure scheduling enhancements were adequately developed and met users’ needs. The audit team determined that the approved specifications were insufficient to ensure the scheduling enhancements would meet VHA’s needs. According to VHA’s information technology project manager, the Office of Information and Technology approved the release of a version of VSE in April 2017. However, the OIG audit team found delays in deployment persisted until the final contract modification for VSE ended in September 2017. VA has since decided to use a standalone scheduling component within the electronic health records system being developed under contract by the Cerner Corporation as a permanent solution. The first standalone scheduling component is planned for deployment in 2020, according to a December 2018 report to Congress. The OIG recommended the assistant secretary for Information and Technology enforce current required project management processes with improved oversight to ensure project planning requirements are adequately defined and supported before starting information technology projects.

The U.S. Postal Service uses contracted delivery suppliers to support mail delivery needs and ensure it meets its universal service obligation. CDS is a contractual agreement between the Postal Service and an individual or company for the delivery and collection of mail for customers. CDS is considered one of the Postal Service’s three primary carrier delivery types (city and rural carriers, and contracted delivery suppliers). CDS suppliers1 are not Postal Service employees, but independent contractors who provide delivery service on specific routes not serviced by city or rural carriers. The objective of our audit was to assess the effectiveness of controls over CDS and its costs.

The U.S. Department of Health and Human Services (HHS), Food and Drug Administration (FDA), did not submit an Office of Inspector General (OIG) clearance document for any of the 166 audit recommendations, which were identified in OIG stewardship reports, during Federal fiscal years (FYs) 2015 and 2016. As a result, all of the recommendations were outstanding, and listed on the stewardship report as past due for resolution, as of September 30, 2016. However, for 134 of the 166 recommendations (from 7 information technology audit reports), FDA did address the audit recommendations in detail, to include statements of corrective actions, in its comments on those reports. These 166 past-due recommendations were procedural in nature; none of them involved dollar amounts such as recommended disallowances.

We received a hotline allegation regarding suspicious fraudulent transactions involving stolen stamps from the North Kenner, LA, Station. An initial investigation confirmed that a Postal Service unit manager had access to large quantities of postage stamp inventory. Further, the manager circumvented controls and manipulated data records for unit reserve stock and sold stamps on eBay® at reduced prices. Unit reserve stock consists of all stamps, stamped paper, and philatelic products in a postal retail unit that has not been assigned to other areas within the unit. Our objective was to determine whether controls over unit reserve stamp stock accountability were adequately designed and operating effectively.

The Patient Protection and Affordable Care Act gave States the option to expand Medicaid coverage to low-income adults without dependent children and established enhanced Federal reimbursement rates (Federal Medical Assistance Percentage, or FMAP) for services provided to beneficiaries enrolled through this group, known as the new adult group. Enhanced Federal reimbursement is defined as a payment made at a higher percentage than the State's standard FMAP rate. These higher FMAP rates raised concerns about States improperly enrolling individuals in the new adult group and the potential for improper payments.

In 2016, the Centers for Medicare & Medicaid Services (CMS) updated its life safety and emergency preparedness regulations to improve protections for all Medicare and Medicaid beneficiaries, including those residing in long-term care facilities (commonly referred to as nursing homes). Updates included requirements that nursing homes have expanded sprinkler systems and smoke detector coverage; an emergency preparedness plan that is reviewed, trained on, tested, and updated at least annually; and provisions for sheltering in place and evacuation. Our objective was to determine whether New York State ensured that selected nursing homes in New York that participate in the Medicare or Medicaid programs complied with CMS requirements for life safety and emergency preparedness.

The Administration for Children and Families' (ACF's) oversight of the Low-Income Home Energy Assistance Program (LIHEAP) did not ensure that grant funds were (1) used to provide the maximum available LIHEAP benefits to eligible households and (2) consistently administered in accordance with Federal laws, regulations, and guidance. (For this audit, we reviewed ACF's oversight in the context of the results of our previous audits of three Indian Tribes' (Tribal grantees') administration of their LIHEAP grant funds.) ACF's oversight of Tribal grantees focused on the reporting of obligated funds and not on whether the grantees had adequate policies and procedures to ensure that they used obligated funds to provide the maximum available LIHEAP benefits to eligible households. Furthermore, ACF selected only a limited number of Tribal grantees for onsite compliance reviews each year. These reviews did not ensure that grantees complied with Federal regulations. ACF did not have adequate policies and procedures to effectively oversee the Tribal grantees' LIHEAP grants.