Federal Reports

This Office of Inspector General Comprehensive Healthcare Inspection Program report describes the results of a focused evaluation of the outpatient settings at the West Texas VA Health Care System and associated outpatient clinics in Texas and New Mexico. This evaluation focused on four key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of careThe OIG issued one recommendation for improvement related to medical staff privileging:• Ongoing Professional Practice Evaluations

The VA Office of Inspector General (OIG) concluded for fiscal year 2021 that VA complied with the Payment Integrity Information Act of 2019. As required, in the materials accompanying its annual financial statement, VA published estimates of improper and unknown payments for susceptible programs. Yet, while assessing compliance, the OIG determined VA can improve its testing procedures for these payments. Improper payments are payments that should not have been made or that were made in an incorrect amount under statutory, contractual, administrative, or other legally applicable requirements, according to the Office of Management and Budget; unknown payments are those a program cannot discern were made to the correct recipient or for the correct amount.The OIG found testing procedures for two programs—Purchased Long-Term Services and Supports, and Medical Care Contracts and Agreements—do not go far enough. Because they do not include reviewing documentation for proof of receipt, they may not identify payments for goods and services never rendered. Identifying and including such payments would increase unknown payment rates.The OIG determined that because of the testing deficiencies, VA understated the improper and unknown payment estimates as follows:• Purchased Long-Term Services and Supports. VA reported approximately $1.9 billion in improper and unknown payments and a rate of approximately 73 percent; the OIG estimated $1.95 billion and approximately 75 percent.• Medical Care Contracts and Agreements. VA reported approximately $159 million in improper and unknown payments and a rate of approximately 16 percent; the OIG estimated $190 million and approximately 19 percent.While these differences were not large, improved testing procedures are needed so that VA’s future estimates remain valid. Therefore, the OIG believes VA needs to ensure adequate documentation is reviewed during payment testing.

Audit of the U.S. Department of the Treasury’sProcess for Its Direct Loan to YRC Worldwide, Inc.Under Section 4003 of the CARES Act

This report presents the results of our audit of Package Tracking Messaging.

Postal Service employees who sustain a work-related injury or occupational disease are covered by the Federal Employees’ Compensation Act (FECA). These benefits include wage-loss compensation, medical and rehabilitation services, and death benefit payments to surviving dependents. The Department of Labor’s (DOL) Office of Workers’ Compensation Program has the exclusive authority to administer, implement, and enforce FECA, including paying claims on behalf of injured employees. The Postal Service manages efforts to return injured employees to work through its Injury Compensation Program. During chargeback year (CBY) 2022 (July 1, 2021, through June 30, 2022) the Postal Service reimbursed $1.31 billion to DOL for its compensation claim costs, including administrative fees.Our objective was to evaluate management’s initiatives to reduce workers’ compensation costs and examine good practices for controlling workers’ compensation activity. We reviewed workers’ compensation data from fiscal year (FY) 2017 through FY 2022 and visited five districts based on management’s implemented cost containment initiatives.