Federal Reports

The independent public accounting firm of Brown & Company CPAs and Management Consultants, PLLC, under contract with the Office of Inspector General, audited Help America Vote Act (HAVA) grants administered by the Michigan Department of State (MDOS), totaling $49.88 million. This included federal funds, state matching funds, and interest and program income earned on the reissued Section 101, reissued Section 251, Election Security, and Coronavirus Aid, Relief, and Economic Security (CARES) Act grants.

The Veterans Health Administration (VHA) purchases community healthcare services by contracting with third-party administrators (TPAs), which in turn contract with community providers. When prescribing drugs, community providers submit prescription requests to be filled at VA pharmacies and must consider VA’s approved formulary drugs before others, which require special authorization (usually a justification for its use). The VA Office of Inspector General (OIG) conducted this audit to determine if VHA’s oversight of TPAs ensured that community providers prescribed special-authorization drugs as required.The OIG determined that community providers rarely submitted initial prescriptions for special-authorization drugs with required justifications, partly because the electronic prescription system lacked the means to include justifications. VA pharmacies reported that ongoing staffing challenges and increased community care prescriptions required additional processing time and caused a backlog. However, VA pharmacies sometimes did not record receipt dates for these prescriptions accurately, which made it difficult for VHA to track delayed processing. The OIG found that community care prescription processing often exceeded VHA’s four-day standard, with an average of about 11 days for processing.These issues occurred partly because of ineffective oversight at multiple levels. VHA did not hold TPAs accountable for making certain that community providers followed formulary procedures for special-authorization drugs. Although TPAs developed formulary training, less than 2 percent of community providers completed it. The OIG questioned about $200.2 million in prescription costs that lacked justification from community providers.The OIG made seven recommendations to the under secretary for health to improve community providers’ compliance when prescribing special-authorization drugs, such as enhancing prescription system capabilities, addressing training requirements, improving VA pharmacies’ documentation of justifications, and clarifying requirements for VA pharmacies to report community providers that are not compliant.

The inspection sought to determine whether the Federal Student Aid office (FSA) established performance measures and indicators for returning borrowers to repayment. We found that FSA needed to establish effective performance measures and indicators to evaluate its performance for returning borrowers to repayment. Although FSA and the Office of the Undersecretary established operational and strategic objectives and operational goals for returning borrowers to repayment, they were not written in specific and measurable terms. In addition, although FSA identified several data metrics as performance measures and indicators for returning borrowers to repayment, they did not include clearly defined targeted percentages, numerical values, milestones, or measurements. Without effective performance measures and indicators, FSA is unable to assess whether it has made progress toward achieving its goals and objectives or if adjustments are needed to improve its performance. Overall, the lack of effective performance measures and indicators may negatively impact FSA’s ability to effectively identify, analyze, and respond to risks related to returning borrowers to repayment.

The Inflation Reduction Act appropriated $500 million for NPS to hire employees in National Park System units or national historic or scenic trails.