Federal Reports

This Office of Inspector General Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the inpatient and outpatient care provided at the VA Central California Health Care System in Fresno, which includes the Fresno VA Medical Center and multiple outpatient clinics in California. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (focusing on emergency department and urgent care center prevention initiatives)The OIG issued two recommendations for improvement in two areas:1. Leadership and organizational risks• Institutional disclosures2. Mental health• Suicide risk evaluations

The objective of this statutory audit was to determine whether the Department complied with the Payment Integrity Information Act of 2019 (PIIA) for FY 2022. We found that the Department did not comply with the PIIA because it did not meet one of the six compliance requirements. Specifically, the Department reported improper payment and unknown payment estimates for the Title I, Special Education, and Education Stabilization Fund programs that exceeded 10 percent. We also determined that the Department’s improper payment and unknown payment estimates for five programs (Title I, Special Education, Education Stabilization Fund, Pell, and Direct Loan) were not reliable. Specifically, for the Title I and Special Education programs, the improper payment and unknown payment estimates were based on inaccurate sampling populations. For the Title I, Special Education, and Education Stabilization Fund programs, the Department’s testing results were inaccurate; and the improper payment sampling and estimation plan for the Pell and Direct Loan programs included nonrandom student-level sampling from some of the compliance audits FSA used to calculate the estimates, which affected the appropriateness of the confidence intervals used in the calculation of the improper payment and unknown payment estimates.

U.S. Immigration and Customs Enforcement (ICE) did not consistently implement effective access controls to restrict access to its network and information technology (IT) systems. Although ICE took a multi-layered approach to managing access for personnel who change positions or leave the component altogether, we determined that ICE did not consistently manage or remove access when personnel separated or changed positions.

Although the Federal Emergency Management Agency (FEMA) worked with its strategic partners to deliver critical medical supplies and equipment in response to COVID-19, FEMA did not effectively manage the distribution process. Specifically, FEMA did not use the Logistics Supply Chain Management System (LSCMS), its system of record for managing the distribution process, to track about 30 percent of the critical medical resources shipped, as required.