Federal Reports

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In response to a hotline complaint, the Office of Inspector General (OIG) reviewed allegations that the Carl T. Harden VA Medical Center (VAMC) in Phoenix, AZ did not consistently process beneficiary travel mileage claims. In response, OIG determined whether the VAMC reimbursed beneficiaries more than once for the same travel, approved travel mileage claims using Post Office Boxes instead of physical addresses, and reimbursed beneficiaries primarily through cash or check and not electronic funds transfer (EFT).We did not substantiate the allegation that VAMC staff improperly reimbursed beneficiaries more than once for the same travel. Although we did not substantiate the allegation, we observed the VAMC did not have written procedures requiring staff to perform actions when automated controls alerted them of potential duplicate claims and payments. Although we determined it was not a widespread issue, we substantiated the allegation that VAMC staff inappropriately approved beneficiary travel mileage claims using Post Office Boxes as beneficiaries’ departure addresses instead of physical addresses, which violated policy. We found this occurred because the VAMC lacked a local quality review program to ensure staff document and use physical addresses when calculating mileage reimbursements.We substantiated the allegation that VAMC staff unnecessarily reimbursed most beneficiary travel in cash, rather than by EFT. However, the VAMC Director, appointed in December 2015, supported the facility's adoption of cash reduction goals and approved a plan to advance those measures soon after her appointment. Accordingly, VAMC staff have been implementing this plan, which has resulted in a significant reduction of the VAMC’s percentage of cash payments. Because we confirmed significant actions have been taken, we did not make any recommendations for this area. We made two recommendations. The VAMC Director concurred with our recommendations, and we will perform follow-up on corrective action implementation.

Head Start grantees are required to have Single Audits conducted in accordance with the Office of Management and Budget Circular A 133 (also known as A-133 audits) for fiscal years beginning before December 26, 2014. The Administration for Children and Families (ACF) is responsible for following up on recommendations made to grantees in A 133 audit reports. We reviewed Federal Audit Clearinghouse (FAC) data for American Indian and Alaska Native (AIAN) Head Start grantees in ACF Regions VI, IX, and X that submitted A-133 audit reports from Federal fiscal years 2013 through 2015.

For calendar years 2014 and 2015, Lincare Pharmacy Services Inc. (Lincare), which is located in Clearwater, Florida, generally complied with Medicare requirements when billing for inhalation drugs. Of the 100 claim lines in our sample, 97 complied with the requirements. However, the remaining three sampled claim lines did not comply with Medicare requirements. Specifically, the beneficiaries’ medical records did not support that the beneficiaries had conditions for which the use of inhalation drugs was considered reasonable and necessary. As a result, Lincare received $48 in unallowable Medicare payments.

This report is designated For Official Use Only. For more information, please contact the IC IG Hotline Team at ICIGHOTLINE@dni.gov.