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 Amarillo Health Care System in Texas. This evaluation focused on five key operational areas:• Leadership and organizational risks• Quality, safety, and value• Medical staff privileging• Environment of care• Mental health (emergency department and urgent care center prevention initiatives)The OIG identified concerns within the medical staff privileging area of review:• Focused Professional Practice Evaluation processes• Privileging request review

The U.S. Environmental Protection Agency Office of Inspector General identified vulnerabilities related to the EPA's network structure, specifically, the Microsoft Office 365, or O365, environment in which little or no network segmentation exists between the EPA proper and the OIG. The EPA's 0365 administrators can modify OIG account settings as well as access and view sensitive data within the O365 environment without the knowledge or input of the OIG, including email and other data of senior OIG employees and sensitive shared email inboxes. Additionally, poor user access controls and limited event logging degrade the OIG's ability to determine details about user activity within the O365 environment.

Under federal law, the Veterans Health Administration (VHA) cannot employ individuals if they have been formally excluded from having a paid position in a federal healthcare program. Exclusions can result from an individual committing healthcare fraud, patient abuse, controlled substance violations, acts resulting in license revocation, and other misconduct as specified by federal law. The List of Excluded Individuals and Entities (LEIE) is maintained by the Department of Health and Human Services Office of Inspector General. LEIE screening is meant to prevent individuals who have been found unsuited for working in a federally funded healthcare program from having access to medical facilities that need to protect their assets, patients, and information systems.The OIG matched VHA personnel pay against LEIE data for the first pay period of January 2022 and found VHA was employing four former nursing professionals excluded from having VHA positions. They had housekeeping, clerical, or support positions—not engaged in patients’ health care. Three of them were on the list because of nursing license revocation or suspension, while the fourth was convicted of healthcare fraud. When notified, VA took prompt action to terminate the employees and the OIG confirmed they are no longer with VHA. VHA leaders also outlined actions to address the process failures the OIG identified. In addition, leaders concurred with the report’s three recommendations for completing those policy and process improvements, taking additional actions to prevent violations from recurring, and conducting a one-time audit to confirm compliance with the federal law outside the review period. The OIG will continue to monitor VA’s progress until sufficient documentation has been received to close the recommendations as implemented.