Federal Reports

The VA Office of Inspector General (OIG) conducted a national review to evaluate specific elements of colonoscope reprocessing at 10 multispecialty community-based outpatient clinics (CBOCs). The OIG reviewed training oversight and documentation, colonoscope reprocessing, and environmental monitoring in sterile processing areas.Colonoscopy carries some risk with the possibility of infection acquired from improperly cleaned medical devices. The Veterans Health Administration (VHA) requires specific training during initial orientation with monthly continuing education for Sterile Processing Services (SPS) staff to maintain technical knowledge. Facility SPS chiefs are responsible for oversight of staff training.The OIG determined that CBOC SPS staff reprocessed and tracked colonoscopes and monitored the environment according to VHA requirements.The OIG identified deficiencies in training and oversight of SPS staff. The OIG found that 50 percent of SPS employees who were required to complete initial training within 90 days did not complete it in the required time frame. Service chiefs at 70 percent of the CBOCs did not ensure that training documentation was complete. The OIG determined that SPS supervisors did not ensure that SPS staff received continuing education at 20 percent of the CBOCs.The OIG made two recommendations to the Under Secretary for Health related to initial SPS training and continuing education.

The VA Office of Inspector General (OIG) assessed VA’s oversight of the Medical/Surgical Prime Vendor-Next Generation (MSPV-NG) Program, under which prime vendors maintain inventories of medical and surgical supplies and restock medical facilities when needed. Specifically, the OIG examined whether medical facility-level staff verified the accuracy of distribution fees invoiced by the prime vendors, and national- and Veterans Integrated Service Network-level staff provided proper oversight of this activity.In February 2016, VA’s Strategic Acquisition Center awarded four MSPV-NG contracts with a cumulative value of about $4.6 billion to prime vendors for medical and surgical supplies. VA pays prime vendors for requested products plus a distribution fee to cover the costs associated with managing medical facilities’ inventories. Medical facilities paid approximately $25.4 million in MSPV-NG distribution fees during fiscal year 2018, according to an official from VHA’s Procurement and Logistics Office.The OIG found VA controls were not sufficient to ensure VA medical facility staff accurately reviewed, verified, or certified distribution fee invoices for the MSPV-NG program. VA also did not ensure staff at medical facilities accurately established and applied the on-site representative rates and paid fees based on annual facility purchases. The MSPV-NG pricing schedule establishes fee rates for on-site representatives based on annual facility purchase amounts. VA establishing a flat fee rate will help mitigate on-site representative fee rate disparities, but in the interim VA still needs to ensure facilities reconcile rate disparities that have occurred and continue to occur.The OIG made 10 recommendations designed to improve oversight of verification and certification of distribution fee invoices and ensure the accuracy of on-site representative fees.

The VA Office of Inspector General (OIG) conducted this review based on a confidential allegation received in March 2019 that employees at the Chicago, Illinois, VA regional benefits office were not following the Veterans Benefits Administration’s (VBA) procedures for correcting administrative errors.To correct administrative errors, employees must complete steps such as assigning numeric codes to identify types of claims or actions needed, making and approving decisions, correcting errors in VBA’s electronic system, properly notifying veterans, and ensuring debts were not improperly created.The OIG substantiated the allegation that Chicago employees did not follow VBA procedures, and based its conclusions on the procedures in place at the time each error was corrected. VBA modified its procedures for correcting administrative errors three times after the review team began work in October 2019.The OIG found claims processors did not properly correct administrative errors in 88 percent of cases reviewed. Errors resulted in improper underpayments of about $59,100 to six veterans, improper overpayments of $18,900 to two veterans, and $5,900 in debts VA had inappropriately collected from eight veterans through January 2020. VBA concurred with all the OIG-identified errors.Generally, errors occurred because claims processors did not sufficiently understand their responsibilities and procedures for correcting administrative errors. Beginning in January 2020, VBA updated its procedures manual with more detailed instructions for controlling administrative errors, determining when administrative decisions are required, preventing debts from being created, ensuring benefits are paid through the correct date, and removing erroneous benefit information from the electronic system. Chicago managers also increased oversight of administrative errors.The OIG recommended the director of the Chicago VA regional office ensure the errors identified by the review team are corrected, monitor the effectiveness of actions taken to improve the accuracy of corrections, and determine whether additional measures are needed.

This report presents the results of our self-initiated audit of Voyager Card Transactions - Brick, NJ, Post Office. The Brick, NJ, Post Office is in the South New Jersey District of the Atlantic Area. This audit was designed to provide U.S. Postal Service management with timely information on potential financial control risks at Postal Service locations.

This audit report is one of a series of OIG reports addressing the identification, reporting, and investigation of incidents of potential abuse or neglect of our Nation’s most vulnerable populations, including the elderly and individuals with developmental disabilities. Our objectives were to determine whether Florida: (1) ensured that nursing facilities reported potential abuse or neglect of Medicaid beneficiaries transferred from nursing facilities to hospital emergency departments; (2) complied with Federal requirements for assigning a priority level, initiating onsite surveys, and recording allegations of potential abuse and neglect; and (3) operated its incident report program effectively.

We audited $212.4 million of costs billed to the Tennessee Valley Authority (TVA) by G·UB·MK Constructors (GUBMK) under Contract No. 11514 to determine if costs billed to TVA were in compliance with contract's terms. We determined the costs billed by GUBMK generally complied with the contract except for $22,545. (Summary Only)

We determined that FEMA did not ensure procurements and costs for debris removal operations in Monroe County, Florida, met Federal requirements and FEMA guidelines.  Specifically, FEMA did not adequately review local entities’ procurements for debris removal projects and reimbursed local entities for questionable costs.  These deficiencies were due to weaknesses in FEMA training and its quality assurance process.  As a result, FEMA approved reimbursement to local entities for nearly $25.6 million (more than $23 million in Federal share) for debris removal projects, including contracts that may not have met Federal procurement requirements, and more than $2 million in questionable costs.  Without improvements to FEMA’s training and project review processes, FEMA risks continuing to expose millions of dollars in disaster relief funds to fraud, waste, and abuse.  We made three recommendations with which FEMA officials concurred.  Based on the information FEMA provided, we consider the three recommendations resolved and open.