OIG Seal
Department of Veterans Affairs, Office of Inspector General
Michael J. Missal, Inspector General

Oversight Reports

Audit of Purchase Card Use To Procure Prosthetics

9/29/2017 | 15-04929-351 | Summary | Report | 5 Recommendations

Legend:   Open|   Closed

No. 1   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health require Prosthetic and Sensory Aids Service conduct periodic analyses of Veterans Health Administration prosthetic purchases to identify commonly used prosthetics that offer opportunities for VA’s Strategic Acquisition Center to leverage Veterans Health Administration’s purchasing power by pursuing Veterans Health Administration-wide or multi-Veterans Integrated Service Network contracts.

No. 2   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health require the Procurement and Logistics Office and Prosthetics and Sensory Aids Service to periodically monitor prosthetic procurements to ensure Veterans Integrated Service Networks and Network Contracting Offices identify and report prosthetics usage and cost data for use in developing Veterans Integrated Service Network contracts when Veterans Health Administration wide or multi-Veterans Integrated Service Network contracts are not possible.

No. 3   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health require the Procurement and Logistics Office to review fiscal years 2015 and 2016 prosthetic purchase card transactions above the micro-purchase limit and submit identified unauthorized commitments to Heads of Contracting Activities for ratification actions.

No. 4   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health direct Heads of Contracting Activities to perform ratification actions for unauthorized commitments identified by the Procurement & Logistics Office review of fiscal years 2015 and 2016 prosthetic purchase card transactions above the micro-purchase limit and consider holding cardholders and their approving officials accountable for unauthorized commitments, as appropriate.

No. 5   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health require the Procurement and Logistics Office to develop a process for conducting periodic reviews to evaluate compliance with the requirements of VHA Directive 1081, VA Procurement Policy Memorandum 2016-02, and the Veterans Health Administration’s Memorandum, Implementation of the Implant Pre-authorization Process.

Total Monetary Impact of All Recommendations

Open: $ 3,120,699,904.00
Closed: $ 0.00

Review of Alleged Use of Wrong VA Funds To Purchase IT Equipment

9/29/2017 | 16-00753-338 | Summary | Report | 3 Recommendations

Legend:   Open|   Closed

No. 1   to Veterans Health Administration (VHA)

We recommended the Veterans Integrated Service Network 23 Director consult with VA’s Office of General Counsel and take necessary corrective actions to correct the funding error related to the purchase of WiFi and cable television services and ensure that appropriate funds are used for future information technology purchases in accordance with VA policy and VA’s Office of General Counsel guidance.

No. 2   to Veterans Health Administration (VHA)

We recommended the Veterans Integrated Service Network 23 Director work with the Chief Financial Officer to determine if an Antideficiency Act violation occurred and take action as deemed appropriate.

No. 3   to Office of Information and Technology (OIT)

We recommended the Acting Assistant Secretary for Information and Technology update the 2016 IT/Non-IT Policy to address the dissemination of decisions and issues that may be systemic across VA.

Total Monetary Impact of All Recommendations

These recommendations have no monetary value.

Legend:   Open|   Closed

No. 1   to Office of Information and Technology (OIT)

We recommended the Acting Assistant Secretary for Information and Technology implement appropriate controls to ensure that Class III software is not installed on VA networks without a formal technical review and authority to operate, and that training is provided to OIT Region 1 staff on the treatment of Class III software.

Total Monetary Impact of All Recommendations

These recommendations have no monetary value.

Legend:   Open|   Closed

No. 1   to Veterans Health Administration (VHA)

We recommended the director of the STVHCS instruct PRMC to stop advising veterans that they may be liable for pre-authorized NVC.

Total Monetary Impact of All Recommendations

These recommendations have no monetary value.

Legend:   Open|   Closed

No. 1   to Veterans Health Administration (VHA)

We recommended the South Texas Veterans Health Care System Director require staff to review all pending orders that are past due to identify those orders which are active and those which need to be canceled because they have been completed or are no longer needed.

No. 2   to Veterans Health Administration (VHA)

We recommended the South Texas Veterans Health Care System Director develop a plan to address any pending exams that are past due to ensure patients who have experienced significant delays receive needed exams.

No. 3   to Veterans Health Administration (VHA)

We recommended the South Texas Veterans Health Care System Director ensure staff review the health care system’s current hard copy scheduling process to reduce inefficiencies related to duplicate orders, inaccurate record keeping, and the inventory of pending orders.

No. 4   to Veterans Health Administration (VHA)

We recommended the South Texas Veterans Health Care System Director ensure Imaging Service staff implement VHA’s Outpatient Radiology Scheduling Policy and Procedures and establish monitoring mechanisms where staff review pending orders at designated intervals and remove duplicate exams to facilitate the timely completion of exams.

No. 5   to Veterans Health Administration (VHA)

We recommended the South Texas Veterans Health Care System Director implement a program to educate and remind clinicians of the processes they should use to avoid the creation of unnecessary duplicate orders.

Total Monetary Impact of All Recommendations

These recommendations have no monetary value.

Legend:   Open|   Closed

No. 1   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health develop standardized national policy and procedures for the health care enrollment program at VA medical facilities.

No. 2   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health implement national oversight of the health care enrollment program to continually review operations and performance of VHA medical facilities.

No. 3   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health provide mandatory and standardized training on eligibility and enrollment to ensure health care applications are processed accurately and timely.

No. 4   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health develop and execute a process to distinguish new applications for health care enrollment in VistA from other registration data.

No. 5   to Veterans Health Administration (VHA)

We recommended the Acting Under Secretary for Health implement a plan to correct current data integrity issues in VistA to improve the accuracy and timeliness of enrollment data.

Total Monetary Impact of All Recommendations

These recommendations have no monetary value.

Legend:   Open|   Closed

No. 1   to Veterans Health Administration (VHA)

We recommended the Director of the West Palm Beach VA Medical Center ensure recruitment efforts are progressing to fulfill cardiology clinic vacancies and that there are sufficient cardiologists for the needs of the Medical Center.

No. 2   to Veterans Health Administration (VHA)

We recommended the Director of the West Palm Beach VA Medical Center ensure all scheduling staff are trained on the requirement to reschedule appointments canceled by the clinic within 14 days of the original appointment date.

No. 3   to Veterans Health Administration (VHA)

We recommended the Director of the West Palm Beach VA Medical Center ensure schedulers are using the clinically indicated or preferred appointment dates when scheduling appointments.

No. 4   to Veterans Health Administration (VHA)

We recommended the Director of the West Palm Beach VA Medical Center ensure supervisors perform the required number of scheduling audits for each scheduler as required by VAMC policy.

Total Monetary Impact of All Recommendations

These recommendations have no monetary value.

Legend:   Open|   Closed

No. 1   to Veterans Health Administration (VHA)

We recommended the Under Secretary for Health require Consolidated Patient Account Centers review a statistical sample of bills issued during fiscal years 2015 and 2016 for the treatment of service-connected veterans to identify erroneously billed amounts that require refunds, and use these results to address internal control deficiencies and assess what additional efforts can be taken to identify and refund erroneously billed amounts.

No. 2   to Veterans Health Administration (VHA)

We recommended the Under Secretary for Health require Consolidated Patient Account Center management to provide billing staff read-only access to the Veterans Benefits Management System to identify potential service-connected bills that require review by Revenue Utilization Review nurses.

No. 3   to Veterans Health Administration (VHA)

We recommended the Under Secretary for Health require Consolidated Patient Account Center management establish oversight procedures to review statistical samples of prescriptions prior to generating bills to veterans and to address any identified systemic or facility-specific billing problems.

No. 4   to Veterans Health Administration (VHA)

We recommended the Under Secretary for Health require Consolidated Patient Account Center management to revise quality assurance reviews to include reviews of pharmacy bills and evaluate whether Revenue Utilization Review nurses correctly validate or make service-connection determinations for veterans’ medical treatment based upon staffing and workload.

No. 5   to Veterans Health Administration (VHA)

We recommended the Under Secretary for Health require Consolidated Patient Account Center management to revise policy and procedure to require Consolidated Patient Account Center staff to adequately provide and document training for VA medical facility staff regarding specific service-connection determination errors.

No. 6   to Veterans Health Administration (VHA)

We recommended the Under Secretary for Health require Consolidated Patient Account Center management to track and monitor incorrect medical provider service-connection determinations and coordinate training to ensure identified issues are appropriately addressed.

Total Monetary Impact of All Recommendations

These recommendations have no monetary value.

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