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Brought to you by the Council of the Inspectors General on Integrity and Efficiency
Federal Reports
Report Date
Agency Reviewed / Investigated
Report Title
Type
Location
Department of Veterans Affairs
Compensation and Pension Proceeds Were Generally Handled Accurately but Some Were Delayed
The VA Office of Inspector General (OIG) audited the Veterans Benefits Administration’s (VBA) handling of “proceeds” to determine whether they are completed accurately and timely. A proceed is an actionable item in the veteran’s or beneficiary’s record that is created when benefits payments are returned to VA instead of being paid, including reasons such as a change of bank account number, a change of address, or a veteran’s death.On December 18, 2019, VBA had more than 7,500 open proceeds totaling about $13 million. At that time, veterans service centers at each regional office handled compensation proceeds. Some veterans and beneficiaries had to wait months to have their funds returned to them, potentially causing financial hardship.The OIG determined that VBA generally handled proceeds accurately but did not always close them within 90 days, a benchmark the OIG used for this audit. The team reviewed 150 closed sample proceeds and determined that 96 percent were handled correctly. However, VBA took more than 90 days to close some proceeds, which totaled an estimated $2.1 million.Service and pension center staff do not have timeliness measures for proceeds incorporated in their performance standards. Setting a timeliness standard would help encourage the closing of these proceeds. The OIG also found that ineffective monitoring contributed to delays in handling proceeds. The Debt Management Center had only limited internal monitoring but instituted new practices for monitoring proceeds in February 2020, shortly after this audit began. VA concurred with the OIG’s recommendations that VBA set a standard time for closing proceeds and develop oversight and monitoring procedures to ensure proceeds are closed promptly.
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 Chillicothe VA Medical Center and multiple outpatient clinics in Ohio. The inspection covers key clinical and administrative processes 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 medical center’s executive leadership team appeared stable. At the time of the virtual site visit, leaders had worked together for almost two months, while some had served in their roles for more than a year. Employee survey data revealed opportunities for the Chief of Staff to improve satisfaction in the workplace. Patients generally appeared happy with their care. The OIG’s review of the medical center’s accreditation findings, sentinel events, and disclosures did not identify any substantial organizational risk factors. Executive leaders were able to speak in depth about actions taken during the previous 12 months to maintain or improve employee satisfaction and patient experiences. Leaders were knowledgeable within their scope of responsibilities about data and/or factors contributing to specific poorly performing Strategic Analytics for Improvement and Learning measures.The OIG issued 12 recommendations for improvement in six areas:(1) Quality, Safety, and Value• Peer review summary reports• Root cause analysis processes(2) Medical Staff Privileging• Ongoing professional practice evaluations• Provider exit review forms(3) Medication Management• Pain management committee processes(4) Mental Health• Suicide prevention training(5) Women’s Health• Women veterans health committee membership and attendance(6) High-Risk Processes• Standard operating procedures• Airflow directional devices• Staff training and competency
Amtrak (the company) contracted with the independent public accounting firm of Ernst & Young LLP to audit its consolidated financial statements as of and for the fiscal year then ended, September 30, 2020, and to provide a report on internal control over financial reporting and compliance with certain provisions of laws, regulations, contracts and grant agreements, and other matters, which they issued on December 17, 2020.1 Because the company receives federal financial assistance, it must obtain an audit performed in accordance with U.S. generally accepted government auditing standards. The contract also required Ernst & Young to perform a Single Audit of the company’s federal financial assistance for the fiscal year ended September 30, 2020, in accordance with the audit requirements of Title 2 U.S. Code of Federal Regulations Part 200, Uniform Administrative Requirements, Cost Principles, and Audit Requirements for Federal Awards (Uniform Guidance). The objective of the Single Audit was to test internal control over compliance with major federal program award requirements and determine whether the company complied with the laws, regulations, and provisions of contracts or grant agreements that may have a direct and material effect on its major federal programs. As required by the Inspector General Act of 1978, we monitored the audit activities of Ernst & Young to help ensure audit quality and compliance with auditing standards. Our review disclosed no instances in which Ernst & Young did not comply, in all material respects, with U.S. generally accepted government auditing standards and Uniform Guidance requirements.