Federal Reports

Following the SolarWinds breach discovery in 2020, CISA improved its ability to detect and mitigate risks from major cyberattacks, but work remains to safeguard Federal networks. CISA coordinates Federal agencies’ defense against cyberattacks, but the SolarWinds response revealed that CISA did not have adequate resources — backup communication systems, staff, or secure space — to effectively respond to threats.

The VA Office of Inspector General (OIG) reviewed the Opioid Safety Initiative (OSI) oversight processes at the VA Northern California Health Care System (facility).In an effort to evaluate the effectiveness of OSI oversight processes at the Veterans Health Administration (VHA), the OIG reviewed data of numerous providers across VHA. Several providers assigned to the facility’s Sacramento VA Medical Center were identified as prescribing “high dose” opioids. The OIG conducted a review of opioid therapy management practices by patient aligned care team providers (providers) and supervisors (supervisors) at the facility, in addition to facility and Veterans Integrated Service Network (VISN) oversight processes for opioid therapy.The OIG determined that supervisors ensured that providers received training on OSI. Facility providers and supervisors implemented safe opioid therapy prescribing practices, including completing informed consents. Facility providers and supervisors completed risk mitigations for patients receiving opioid therapy, including state prescription drug monitoring and urine drug screens. For calendar year 2021, facility completion rates for patients prescribed opioid therapy met or exceeded the VISN performance goal for informed consents (97 percent), state prescription drug monitoring (99 percent), and urine drug screens (89.8–93.9 percent).Facility providers had knowledge of VHA recommendations for a pain assessment to be completed every three months, with a completion rate of 73.6 percent over the last 100 days during the inspection.Facility and the VISN had staff, committees, and teams as required to provide oversight and support integration of the OSI into primary care.The facility did not have a required policy providing local guidance on state prescription drug monitoring and the facility pain management policy provided outdated guidance. The Facility Director concurred with the OIG’s two recommendations related to creating and updating the policies.

Deputy Inspector General for Audits, Evaluations, and Special Projects’ Testimony before the Committee on Financial Services Subcommittee on Oversight and Investigations, U.S. House of Representatives, March 8, 2023

Roll-up of the Independent Review of 4003(b) Loan Recipients’ Validation Memos Audit Memorandum Number SIGPR-A-22-003-17