Open Recommendations

Ensure the Office of Integrated Veteran Care strengthens controls to monitor the third-party administrators to ensure non-VA providers’ completion of the VA Opioid Safety Initiative training module.

The Under Secretary for Health collaborates with the region 2 third-party administrator to ensure that community care providers submit documentation of care to the Veterans Health Administration including treatments provided specific to opioid risk mitigation (urine drug screening, prescription drug monitoring program checks) and all prescriptions, to include urgently/emergently prescribed opioids and utine/maintenance opioid prescriptions.

The Under Secretary for Health develops and implements action requiring community care network providers to document evidence of application of Opioid Safety Initiative risk mitigation strategies when treating a veteran to whom they have rescribed opioids, and monitor compliance as part of their Community Provider Opioid Prescribing Practice reviews.

The Under Secretary for Health develops and implements action requiring community care network providers to conduct and document completion of state prescription drug monitoring program queries consistent with VHA policy, prior to prescribing controlled substances, regardless of whether the prescriptions are urgent, emergent, routine or maintenance prescriptions and monitor compliance as part of their Community Provider Opioid Prescribing Practice reviews.

The Under Secretary for Health develops and implements a process to oversee compliance of VHA’s medication reconciliation process for patients receiving care in the community who are prescribed opioids to include recording of the prescriptions in the non-VA medication section of the medication profile.

The Under Secretary for Health consults with the Office for Integrated Veteran Care to determine the value of including a review of community care network provider documentation for evidence of prescription drug monitoring program queries as a required element in VA’s Guidance for Community Provider Opioid Prescribing Practices Review.

The Under Secretary for Health develops and implements action requiring community care network providers to document evidence of application of Opioid Safety Initiative risk mitigation strategies when treating a veteran to whom they have prescribed opioids, and monitor compliance as part of their Community Provider Opioid Prescribing Practice reviews.

Incorporate the 2021 Restraint and "No Knock" Guidance in a DOJ Directive or another appropriate format to ensure permanence.

In coordination with the BOP and USMS: (a) evaluate what use-of-force requirements and restrictions should apply to custodial situations, and (b) ensure these requirements are incorporated into DOJ, BOP, and USMS policies.

Evaluate components' determination on the applicability of DOJ's 2021 Restraint and "No Knock" Guidance and 2022 Use-of-Force Policy to task force officers and contractors acting in a law enforcement capacity to ensure that legal and operational risks are adequately mitigated.

Ensure components' training programs align with and accomplish the DOJ's expectations for use-of-force requirements and consider developing a framework for components to coordinate on best practices and opportunities for improvement.

Amend policies to clearly instruct employees to delete self-employment income (SEI), rather than transfer it to the Earnings Suspense File (ESF), when the numberholder under whose personal information the earnings were reported disclaims the earnings.

Take appropriate action (for example, conduct additional training, update policy and user guides, send emergency messages) to ensure employees process earnings adjustments in accordance with policy.

Delete all disclaimed SEI for Tax Years 2012 through 2019 that remain in the ESF unless the earnings were reported with a name that clearly differs from that on the earnings record to which they were originally posted.

CMS should pursue one or more payment changes that could further realize savings from biosimilars for Part B and enrollees.

Develop policies and procedures to implement the District of Columbia OIG's expanded law enforcement authority and ensure that Unit investigators receive training on the new authorities.

Build upon its efforts with the District's Medicaid agency to increase fraud referrals from the MCOs.

Ensure that supervisory reviews of case files are conducted and documented in accordance with Unit policy.

Ensure that all convictions and adverse actions are reported to Federal partners within the appropriate timeframes.

We recommend the Executive Associate Director for Management and Administration ensure ICE appoints appropriately certified CORs to oversee high-risk transportation services contracts.

We recommend the Executive Associate Director for Management and Administration ensure COs issue COR appointment letters to CORs who do not have them and reissue outdated COR appointment letters.

We recommend the Executive Associate Director for Management and Administration develop and implement procedures to ensure contracting staff issue COR appointment letters and maintain them in contract files.

We recommend the Executive Associate Director for Enforcement and Removal Operations develop and implement guidance to ensure that Enforcement and Removal Operations develops QASPs for contracts that include specific methods for monitoring contractor compliance with contract terms and develop procedures to ensure CORs use the QASPs as part of their oversight activities.

We recommend the Executive Associate Director for Enforcement and Removal Operations evaluate the workload for CORs and determine if sufficient resources are allocated to adequately oversee contracts and, based on the evaluation, develop, and implement a plan to more effectively manage or obtain additional personnel resources.

We recommend the Executive Associate Director for Management and Administration recover any monies, including the $408,875 identified in this report, determined to have been paid toward inaccurate charges or costs not supported by documentation.