Federal Reports

Veterans Benefits Administration (VBA) staff need access to the full range of Veterans Health Administration (VHA) records for proper benefits claims processing. In October 2020, VBA officials emailed a memo instructing processors to search for, identify, and “flash” claims (affix electronic tags) from veterans with records in VA’s new electronic health system for proper routing to a select group of staff with access to those records. The Office of Inspector General (OIG) assessed whether claims processors followed VBA guidance for identifying and routing claims from veterans with records in the new electronic health system.The OIG found 21,057 rating decisions were completed for veterans with records in the new system from August 1, 2021, through July 31, 2022. Of those, 5,605 claims (27 percent) were either missing a flash or the flash was added after staff decided the claim. The review team found, however, from a judgmental sample of 30 decisions that the missing flashes did not ultimately affect veterans’ benefits in those instances.Still, VBA leaders must ensure all benefits claims from veterans with records in the new electronic health system are checked before they are decided by VBA personnel with access. Staff must satisfy their duty to assist veterans in obtaining all evidence, including relevant VA medical records, before deciding a claim. If not completed, veterans may not receive the benefits to which they are entitled. Therefore, the OIG concluded VBA should strengthen its oversight to confirm a flash is applied to all claims from veterans with records in the new system.VBA concurred with the OIG’s two recommendations to conduct refresher training and update written guidance to improve VBA staff’s handling of claims involving records in the new electronic health system and strengthen oversight by clarifying staff accountability for failure to consider all evidence.

The VA Office of Inspector General (OIG) assessed an allegation and reviewed processes related to admission and treatment of patients who needed services that were unavailable at the Fayetteville VA Coastal Health Care System (facility).The OIG did not substantiate that the chief of medicine forced a hospitalist to admit a patient who needed services that were unavailable at the facility.The facility had limited inpatient cardiology and surgical services available; however, patients with needs that exceeded the facility’s capabilities were transferred to another facility.Although hospitalists reported concerns about providing medical coverage for inpatient and outpatient services, the coverage responsibilities were not outside the scope of hospitalists’ duties outlined in policy.Peers completed peer reviews and the OIG did not find evidence that peer reviews resulted in punitive actions.The OIG identified the following deficiencies:• Inpatient echocardiogram interpretations were delayed; however, no adverse events were identified.• An intensive care unit (ICU) policy and procedure permitted admission of patients requiring Continuous Renal Replacement Therapy, although the facility did not have resources to support the treatment.• Hospitalists’ failed to use the patient safety event reporting system, which may have impeded evaluation of potential system-wide issues.• Veterans Health Administration’s privileging policy was not followed to ensure that an intensivist was granted ICU privileges.• Professional practices evaluations were not completed for intensivists.The OIG made one recommendation to the Veterans Integrated Service Network Director related to privileging processes and five recommendations to the Facility Director related to echocardiogram interpretation, ICU procedure and policy, staff education on hospitalist coverage, patient safety reporting, and professional practice evaluations.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements.

The audit objectives were to determine whether program funds were managed in accordance with the ARC and Federal grant requirements.

Our objective was to determine whether USPTO’s patent application classification and routing processes were effective. Specifically, we determined whether (1) USPTO adequately ensured that classification contractors were providing quality patent classification and reclassification services; (2) USPTO examiners properly challenged claim indicator (known as “C-star” or C*) classifications and whether USPTO properly resolved challenges; and (3) USPTO effectively designed and implemented Cooperative Patent Classification (CPC) system-based routing. We found that USPTO’s patent classification and routing processes were not effective. Specifically, we found that:I. USPTO did not ensure effective contract oversight for classification services. II. USPTO lacked adequate controls to ensure that classification challenges were efficiently and effectively submitted and adjudicated. III. USPTO did not effectively design and implement CPC-based routing.