Federal Reports

VA is authorized by statute to procure healthcare resources from affiliates on a sole-source basis without regard to laws or regulations that require competition. VA policy requires that contracting officers request an Office of Inspector General (OIG) review or audit for any sole-source healthcare proposal with an anticipated annual value of at least $400,000. The OIG provides information that contracting officers may use as they negotiate fair and reasonable prices. In fiscal year 2023, the OIG completed 15 audits of sole-source healthcare proposals. The combined estimated contract value of these 15 preaward audits was about $125.8 million, and the OIG team identified approximately $37.3 million in potential cost savings. Following the OIG audits, the Veterans Health Administration sustained about $9.2 million in cost savings.Thirteen proposals reviewed had full-time-equivalent pricing. For these 13 proposals, the OIG determined the hourly rate pricing offered to the government was higher than the supported amounts, and the OIG recommended contracting officers obtain lower prices than those offered to the government.Two proposals reviewed had both hourly rate pricing and per-procedure pricing. The OIG found the affiliate offered rates higher than current Medicare rates for per-procedure pricing. In these two audits, the OIG recommended reimbursement rates that were 100 percent of the current Medicare rates for the per-procedure portion of the affiliate’s proposals.Finally, for 10 of the 15 contract proposals examined, the OIG found potential conflicts of interest for VA personnel who may be involved in the acquisition process and who also hold a position with the affiliate. In each instance, the OIG recommended the contracting officer request an opinion from VA’s Office of General Counsel as to whether these individuals would have a financial interest in the proposal.

The Federal Election Commission (FEC) OIG reviewed the system of quality control for the audit organization of the Federal Trade Commission (FTC) OIG in effect for the year ended March 31, 2024. A system of quality control encompasses the OIG's organizational structure and the policies adopted and procedures established to provide it with reasonable assurance of conforming in all material respects with Government Auditing Standards and applicable legal and regulatory requirements.The FTC OIG received an external peer review rating of pass. In the opinion of the FEC OIG, the system of quality control for the audit organization of the FTC OIG in effect for the year ended March 31, 2024, was suitably designed and complied with to provide the FTC OIG with reasonable assurance of performing and reporting in conformity with applicable professional standards and applicable legal and regulatory requirements in all material respects.

This report presents the results of our performance of the procedures agreed upon by the Office of the Chief Financial Officer of the U.S. Office of Personnel Management (OPM). The report responds to the U.S. Office of Management and Budget’s requirements to assist the OPM in assessing the reasonableness of employee withholdings and U.S. Postal Service contributions reported in the Report of Withholdings and Contributions for Health Benefits, Life Insurance and Retirement.

The VA Office of Inspector General (OIG) conducted this inspection to assess the VA Pittsburgh Healthcare System’s stewardship and oversight of funds. This inspection assessed the following financial activities and administrative processes to determine whether appropriate controls and oversight were in place: managerial cost accounting information, open obligations oversight, purchase card use, and supply chain management operations.The OIG found the healthcare system did not consistently use managerial cost accounting information to enhance efficiency, help reduce costs, and make business decisions, and the system’s use did not fully align with federal financial accounting practices.The healthcare system did not fully comply with VA policies on obligations oversight, resulting in an estimated $87,000 that could have been put to better use and about $63,000 from accruals that were not reviewed and canceled in a timely manner. The system could improve management of open obligations by enhancing reviews of inactive obligations and creating an escalation process when services do not provide status of open orders.Concerning purchase card transactions, the OIG estimated the healthcare system may have incurred about $403,000 in questioned costs because of split purchases. The system could improve efficiency by complying with VA policies on split purchases or by considering contracts.Finally, the OIG found the healthcare system’s supply chain management did not ensure days-of-stock-on-hand metrics were met or that supply chain data were accurate. To improve inventory management, the system could strengthen processes and procedures to ensure stock data are recorded correctly and routinely monitored. Facility leaders reported that staffing shortages may have affected local oversight.The OIG made six recommendations to the healthcare system director. The recommendations address issues that, if unattended, may eventually interfere with financial efficiency practices and the stewardship of VA resources.