Federal Reports

Alpha Painting & Construction Company, Inc., an industrial painting and construction company based in Baltimore, was sentenced November 14, 2019, in United States District Court, Eastern District of Pennsylvania, to five-years’ probation, a $500,000 fine, and forfeiture of $10.9 million. Alpha was previously found guilty of conspiracy, wire fraud, and false statements related to a multimillion-dollar fraud scheme.The scheme involved two Pennsylvania Department of Transportation contracts to rehabilitate bridges in the Philadelphia area including the 30th Street Station Bridge and Girard Point Bridge. The terms of the contracts required Alpha to use a qualified Disadvantaged Business Enterprise to provide supplies for the projects. Instead, Alpha used a now defunct DBE as a pass-through to create the appearance that DBE program requirements had been met. In exchange for participating in the scheme, the DBE received a percentage of funds garnered from falsified invoices it submitted, according to court documents. In addition, Alpha falsified invoices from out of state projects including an Amtrak bridge project to use as DBE credits.Agents from Amtrak’s Office of Inspector General, along with the U.S. Department of Transportation OIG, the U.S. Department of Labor OIG, and the FBI investigated the case.

Medicare contractors are required to separately account for the Medicare segment pension plan assets based on the requirements of Cost Accounting Standards (CAS) 412 and 413. The U.S. Department of Health and Human Services, Office of Inspector General (OIG), Office of Audit Services, Region VII pension audit team reviews the Medicare segment pension assets to ensure compliance with Federal regulations.

Medicare contractors are required to separately account for the Medicare segment pension plan assets based on the requirements of Cost Accounting Standards 412 and 413. The U.S. Department of Health and Human Services, Office of Inspector General (OIG), Office of Audit Services, Region VII pension audit team reviews the Medicare segment pension assets to ensure compliance with Federal regulations.

The VA Office of Inspector General (OIG) conducted an inspection in response to a request from Senator Richard Blumenthal to review issues related to Surgical and Sterile Processing Services (SPS) within the VA Connecticut Healthcare System (system). The request came after an unannounced survey of the system by The Joint Commission (TJC) in February 2018 and a subsequent site review by VHA’s National Program Office for Sterile Processing (NPOSP) in May 2018. Both reviews found deficiencies in the system’s SPS. System leaders began an immediate reduction in SPS reprocessing of instruments and limited Surgical Services procedures to focus efforts on correcting the SPS deficiencies. This inspection focused on the implementation of TJC and NPOSP recommendations; SPS standard operating procedures (SOPs), training, competence, and staffing; surgical cancellations and outsourcing to the community; patient safety and undue burden; and surgical and post-operative infection rates. The OIG team identified additional concerns related to leaders’ decision-making and actions, how the current infrastructure (specifically aging buildings) impacted remediation, and the residency program. The OIG made two recommendations to the Veterans Integrated Service Network Director related to oversight of timely completion of the OIG’s recommendations and hiring actions. The OIG made nine recommendations to the System Director related to inclusion of operating room, surgery, and SPS clinical leaders in remediation efforts; an action plan to establish communication, foster collaboration, and restore trust in system leaders; oversight for the timely completion of pending projects impacting Surgical Services; the development, review, and revision of SOPs and a sustainable SOP maintenance process; SPS staff training and competencies; SPS staffing plan maintenance; readiness evaluation of supplies and equipment prior to anesthetizing a patient; evaluation of the impact and identified needs of the residency programs; and collaboration between the System and Veterans Integrated Service Network 1 Director.

This Comprehensive Healthcare Inspection Program provides a focused evaluation of the quality of care delivered at the VA Connecticut Healthcare System, covering leadership, organizational risks, and key processes associated with promoting quality care. Focused areas were Quality, Safety, and Value; Medical Staff Privileging; Environment of Care; Medication Management: Controlled Substances Inspections; Mental Health: Military Sexual Trauma Follow-Up and Staff Training; Geriatric Care: Antidepressant Use among the Elderly; Women’s Health: Abnormal Cervical Pathology Results Notification and Follow-Up; and High-Risk Processes: Emergency Department and Urgent Care Center Operations. At the time of the OIG site visit, the executive team, except for the acting chief of staff, had been working together for over two years. The facility average for selected survey leadership questions was generally similar to the VHA average. All four patient survey results reflected better care ratings than the VHA average. The OIG’s review of the facility’s accreditation findings, sentinel events, disclosures, and patient safety indicator data did not identify any substantial organizational risk factors. The leadership team should continue to take actions to sustain and improve performance of measures contributing to the Strategic Analytics for Improvement and Learning “5-star” and community living center “1-star” quality ratings. The OIG issued 13 recommendations for improvement: (1) Medical Staff Privileging • Focused and ongoing professional practice evaluation processes (2) Controlled Substances Inspections • Appointment limits of controlled substances inspectors • Rotation of controlled substance areas for inspection • Reconciliation of controlled substances dispensed from and returned to pharmacy • Routine inspections by controlled substances coordinator • Review of override reports (3) Military Sexual Trauma Follow-up and Staff Training • Primary care and mental health providers’ training (4) Antidepressant Use among the Elderly • Patient/caregiver education and understanding of medications • Medication reconciliation (5) Abnormal Cervical Pathology Results and Follow-Up • Patient notification of abnormal results