Federal Reports

The OIG examined whether the VA Office of Community Care accurately reimbursed third-party administrators under the Veterans Choice Program for payments made to community healthcare providers for services to veterans during the audit period. This is the third OIG report on healthcare claims payments under the Choice program. It focuses on claims processed through the Plexis Claims Manager system that were paid from February 21, 2017, through December 31, 2018. The audit team found that the Office of Community Care reimbursed third-party administrators at rates higher than what was typical for the same or similar medical services in a given geographic area. The office could have saved approximately $132.1 million during the period audited if it reimbursed third-party administrators at verifiable usual and customary rates, as required by the governing contract. Additionally, the Office of Community Care did not fully implement prior OIG recommendations to develop effective payment and internal control processes for the Choice program. As a result, the office made about $73 million in overpayments to Choice third-party administrators for medical services provided under the program. These errors were made because the appropriate payment rate was not used. The OIG will continue to monitor all recommendations. The OIG made eight recommendations to the Office of Community Care in this report to prevent and address payment errors under current and future contracts (as the Choice program has ended and other community care programs continue).

The Postal Service processes international election and political mail for eligible U.S. citizens throughout the world. Military and diplomatic members and their families or other U.S. citizens located in foreign countries can use or receive these types of mail. Election mail is any item mailed to, or from, authorized election officials that enables citizens to participate in the voting process. For example, local election offices in the U.S. send ballots or other election materials to international recipients and the international voters mail their completed election ballots back. Political mail is related campaign or messaging mail, and generally entails only outbound operations. Our objective was to evaluate the Postal Service’s preparedness for processing international election mail, including military and diplomatic mail.

Our objective was to determine whether the Postal Service is properly paying its injured employees.