Federal Reports

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.

Seek link below for the full report, report summary, multimedia or any agency follow-up.

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.

U.S. Customs and Border Protection (CBP) plays a critical role in the Nation’s efforts to interdict dangerous substances and prohibited items at U.S. ports of entry and keep these materials from harming the American public. An important part of CBP’s mission is preventing foreign countries from importing illegal drugs such as opioids into the U.S. CBP is experiencing a rise in seizures of synthetic opioids such as fentanyl that upon exposure can kill in minutes. CBP’s Office of Field Operations (OFO) Fines Penalties and Forfeitures Division stores, manages, and disposes seized property, including illicit drugs such as fentanyl. During our ongoing audit of CBP’s storage of seized drugs at permanent drug vaults we visited, we determined that CBP does not adequately protect its staff from the dangers of powerful synthetic opioids. Specifically, CBP has not always made medications designed to treat narcotic overdose available in case of accidental exposure. This occurred because CBP lacks an official policy requiring standard workplace practices for handling fentanyl and safeguarding personnel against exposure. In addition, CBP does not require mandatory training for its staff to provide an understanding of the hazards of fentanyl and methods to combat accidental exposure. As a result, CBP staff is at increased risk of injury or death in case of exposure. We made one recommendation to help CBP provide its components with guidance, knowledge, and tools to handle and reverse overdoses from fentanyl and other opioids.