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

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OIG Reports

| 22-03768-156 | Summary | Report

Recommendations (9)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to establish a plan to use VA’s cost accounting system information for the development of relevant, detailed cost information and to identify alternative ways to reduce costs and enhance efficiency as identified by VA financial policy.

No. 2   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to consider a plan to align VA Milwaukee Healthcare System financial management practices with federal financial accounting standard practices. This could include using cost information for performance measurement, budgeting and cost control, and making economic choices.

No. 3   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to ensure initiating services communicate status of delivered orders in a timely manner so healthcare system finance staff can comply with VA Financial Policy, vol. 2, chap. 5, “Obligations Policy,” by ensuring monthly that proper accruals have occurred.

No. 4   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to collaborate with the Veterans Integrated Service Network chief financial officer and network contracting office to establish a monthly prioritized listing of contract modifications and canceled orders for goods or services that have not been addressed by contracting officers to ensure modification actions are completed.

No. 5   to Veterans Health Administration (VHA)

The Veterans Integrated Service Network 12 director to work with the network contracting office to amend the current contract or establish a new contract to include all needed laboratory tests.

No. 6   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to establish controls to confirm approving officials and purchase cardholders review purchases for VA policy compliance and ensure contracting is used when it is in the best interest of the government.

No. 7   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to require purchase cardholders to submit a request for ratification for any unauthorized commitments identified.

No. 8   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to develop and implement a plan to ensure data accuracy and reliability in the Generic Inventory Package per Veterans Health Administration policy.

No. 9   to Veterans Health Administration (VHA)

The VA Milwaukee Healthcare System director to develop better access controls over the contingency space, to ensure less accessibility to reduce missing inventory.

Total Monetary Impact of All Recommendations

Open: $ 8,800,000.00
Closed: $ 0.00

| 22-03503-131 | Summary | Report

Recommendations (12)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

Ensure that healthcare system finance office staff are made aware of all VA financial policy requirements in the review and management of inactive open obligations, and deobligate any identified excess funds.

No. 2   to Veterans Health Administration (VHA)

Ensure cardholders comply with VA financial policy record retention requirements

No. 3   to Veterans Health Administration (VHA)

Establish controls to confirm approving officials and purchase cardholders review purchases for VA policy compliance and ensure contracting is used when it is in the best interest of the government.

No. 4   to Veterans Health Administration (VHA)

Require purchase cardholders to submit a request for ratification for any unauthorized commitments identified.

No. 5   to Veterans Health Administration (VHA)

Ensure the chief supply chain officer establishes local processes and procedures so that all necessary reports are routinely monitored on the Supply Chain Common Operating Picture, the Generic Inventory Package, or other inventory sites or software systems to ensure performance measures are maintained, as required in the Veterans Health Administration’s Directive 1761, Supply Chain Management Operations.

No. 6   to Veterans Health Administration (VHA)

Ensure supply chain managers implement a plan for staff training to increase awareness of internal controls and data reliability issues, such as conversion factor, within the Generic Inventory Package.

No. 7   to Veterans Health Administration (VHA)

Ensure the chief of supply chain services provides quarterly physical inventory memoranda of “A” classified items to Veterans Integrated Service Network personnel, as required in the Veterans Health Administration’s Directive 1761, Supply Chain Management Operations.

No. 8   to Veterans Health Administration (VHA)

Ensure the chief supply chain officer reviews the facility item master file edit access list of all individuals at the VA medical facility who have permissions to enter or modify data within the item master file each calendar year, as required in the Veterans Health Administration’s Directive 1761, Supply Chain Management Operations.

No. 9   to Veterans Health Administration (VHA)

Develop formalized processes for monitoring and achieving identified efficiency targets and use available pharmacy data to make business decisions.

No. 10   to Veterans Health Administration (VHA)

Establish measures to improve compliance with the VA directive to avoid end-of-year pharmaceutical purchases.

No. 11   to Veterans Health Administration (VHA)

Develop a plan to align inventory management practices, such as the use of handheld scanners, bar code labeling, and ABC inventory analysis methodology with VHA policy.

No. 12   to Veterans Health Administration (VHA)

Establish processes to ensure compliance with the Veterans Health Administration directive to complete the B09 reconciliation process.

Total Monetary Impact of All Recommendations

Open: $ 16,044,457.00
Closed: $ 0.00

| 22-02989-103 | Summary | Report

Recommendations (14)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to ensure that healthcare system finance office staff and initiating services are aware of policy requirements to conduct reviews on all inactive open obligations and deobligate any identified excess funds as required by VA Financial Policy, vol. 2, chap. 5, “Obligations Policy.”

No. 2   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to ensure that healthcare system finance office staff and initiating services that healthcare system staff are conducting finance quality assurance reviews of obligations that were inactive for more than 90 days, as required by Veterans Health Administration Directive 1733, “VHA Finance Quality Assurance Reviews.”

No. 3   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to ensure cardholders comply with record retention, prior approval, and purchase card reconciliation requirements as required by VA Financial Policy, vol. 16, chap. 1B, “Government Purchase Card for Micro-Purchases.”

No. 4   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to ensure cardholders verify that vendors have removed all state and local sales taxes from orders, if applicable.

No. 5   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to ensure authorizing officials implement internal controls over government purchase card activities to ensure compliance with the Government Purchase Card Program.

No. 6   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to establish internal controls to help ensure the healthcare system monitors the Medical/Surgical Prime Vendor formulary for updates, converts supplies to the prime vendor in the item master file, identifies the prime vendor as the mandatory source for these items in the Generic Inventory Package, and properly sets up Medical/Surgical Prime Vendor supply items in VA’s ordering system.

No. 7   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to develop a plan to improve collaboration with the prime vendor and its on-site representative to ensure adequate stock is available to meet orders, reduce the need for the healthcare system to use nonprime vendors, and communicate the healthcare system’s usage and in-stock timing needs.

No. 8   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to ensure a qualified Medical/Surgical Prime Vendor contracting officer’s representative is appointed and performs the required delegated duties.

No. 9   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to establish internal controls to help ensure the healthcare system submits national contract waivers and justifications prior to purchasing available formulary items from nonprime vendor sources.

No. 10   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to ensure that prime vendor contract performance issues are routinely reported to the Medical Supplies Program Office and Strategic Acquisition Center using established Veterans Health Administration reporting tools.

No. 11   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to develop formalized processes for monitoring and achieving identified efficiency targets and use available pharmacy data to make business decisions.

No. 12   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to develop and implement a plan to achieve an inventory turnover rate closer to the Veterans Health Administration’s recommended level.

No. 13   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director to develop and implement a plan to report the results of facility-based inventory audits of noncontrolled drug line items, and any follow-up actions taken, as required by Veterans Health Administration policy.

No. 14   to Veterans Health Administration (VHA)

The VA New York Harbor Healthcare System director establish processes to ensure compliance with the Veterans Health Administration directive which requires that B09 reconciliations are signed by the lead pharmacy technician and include appropriate supporting documentation.

Total Monetary Impact of All Recommendations

Open: $ 44,170,312.00
Closed: $ 0.00

| 22-01721-35 | Summary | Report

Recommendations (10)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

Ensure that healthcare system finance office staff and initiating services are made aware of policy requirements to conduct reviews on all inactive open obligations and deobligate any identified excess funds as required by VA Financial Policy, vol. 2, chap. 5, “Obligations Policy.”

No. 2   to Veterans Health Administration (VHA)

Ensure the healthcare system staff are conducting the accounting operations finance quality assurance review, including the review of undelivered orders, as required by Veterans Health Administration Directive 1733, VHA Finance Quality Assurance Reviews.

No. 3   to Veterans Health Administration (VHA)

Establish controls to confirm approving officials and purchase cardholders review their purchases and make sure contracting is used when it is in the best interest of the government.

No. 4   to Veterans Health Administration (VHA)

Review all invoices for continuous positive airway pressure machines for overcharges.

No. 5   to Veterans Health Administration (VHA)

Develop a control to ensure required supporting documentation is received from vendors that ship directly to veterans.

No. 6   to Veterans Health Administration (VHA)

Ensure all supplies are entered into the Generic Inventory Package as required by Veterans Health Administration policy.

No. 7   to Veterans Health Administration (VHA)

Develop and implement a plan to ensure data accuracy and reliability in the Generic Inventory Package per Veterans Health Administration policy.

No. 8   to Veterans Health Administration (VHA)

Develop and implement a plan to achieve an inventory turnover rate closer to the Veterans Health Administration–recommended level.

No. 9   to Veterans Health Administration (VHA)

Develop a plan to align inventory management practices, such as the use of handheld scanners, barcode labeling, and ABC inventory analysis methodology, with VHA policy.

No. 10   to Veterans Health Administration (VHA)

Establish processes to ensure compliance with the Veterans Health Administration directive to complete the B09 reconciliation process.

Total Monetary Impact of All Recommendations

Open: $ 136,600.00
Closed: $ 0.00

| 22-01565-29 | Summary | Report

Recommendations (10)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

Ensure that healthcare system finance office staff are made aware of policy requirements and that reviews are conducted on all inactive open obligations, and deobligate any identified excess funds as required by VA Financial Policy, vol. 2, chap. 5, “Obligations Policy.”

No. 2   to Veterans Health Administration (VHA)

Ensure cardholders comply with record retention requirements as required by VA Financial Policy, vol. 16, chap. 1B, “Government Purchase Card for Micro-Purchases,”

No. 3   to Veterans Health Administration (VHA)

Establish controls to confirm approving officials and purchase cardholders review purchases for VA policy compliance and ensure contracting is used when it is in the best interest of the government.

No. 4   to Veterans Health Administration (VHA)

Require purchase cardholders to submit a request for ratification for any unauthorized commitments identified.

No. 5   to Veterans Health Administration (VHA)

Ensure purchase card reviews are performed as required by VA Financial Policy, vol. 16, chap. 1B, “Government Purchase Card for Micro-Purchases,”

No. 6   to Veterans Health Administration (VHA)

Ensure the chief of supply chain services establishes local processes and procedures so that all necessary reports are monitored on Supply Chain Common Operating Picture, the Generic Inventory Package, or other inventory sites or software systems, on a routine basis, as required in the Veterans Health Administration’s Directive 1761 Supply Chain Management Operations.

No. 7   to Veterans Health Administration (VHA)

Ensure supply chain management staff implement a plan for staff training to increase awareness of internal controls and data reliability within the Generic Inventory Package.

No. 8   to Veterans Health Administration (VHA)

Ensure the chief of supply chain services signs quarterly physical inventory memorandums of “A” classified items and make them available to Veterans Integrated Service Network personnel as required in the Veterans Health Administration’s Directive 1761 Supply Chain Management Operations.

No. 9   to Veterans Health Administration (VHA)

Develop and implement a plan to increase inventory turnover to meet the level recommended by the Veterans Health Administration Pharmacy Benefits Management Office.

No. 10   to Veterans Health Administration (VHA)

Develop and implement a plan to complete monthly B09 reconciliation consistently to ensure discrepancies are corrected in a timely manner.

Total Monetary Impact of All Recommendations

Open: $ 0.00
Closed: $ 26,903,102.00

| 22-00208-221 | Summary | Report

Recommendations (8)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

Ensure that healthcare system finance office staff are made aware of policy requirements and that reviews are conducted on all inactive open obligations as required by VA Financial Policy, vol. 2, chap. 5, “Obligations Policy.”

No. 2   to Veterans Health Administration (VHA)

Require the finance office to perform quarterly compliance reviews of pharmacy invoice reconciliations.

No. 3   to Veterans Health Administration (VHA)

Develop a plan to work with the prime vendor to address having adequate stock to meet orders, reducing the need for the healthcare system to use nonprime vendors.

No. 4   to Veterans Health Administration (VHA)

Ensure the healthcare system submits Medical/Surgical Prime Vendor–Next Generation waiver requests and obtains approval before purchasing available formulary items from nonprime vendor sources.

No. 5   to Veterans Health Administration (VHA)

Ensure logistics staff and the contracting officer’s representative use the tools available to inform the Medical Supplies Program Office and Strategic Acquisition Center of prime vendor performance concerns and challenges.

No. 6   to Veterans Health Administration (VHA)

Develop formalized processes for monitoring and achieving identified efficiency targets and use available pharmacy data to make business decisions.

No. 7   to Veterans Health Administration (VHA)

Develop and implement a plan to increase inventory turnover to the Veterans Health Administration‑recommended level.

No. 8   to Veterans Health Administration (VHA)

Develop and implement a plan to complete facility-based inventory audits of noncontrolled drug line items in compliance with Veterans Health Administration policy.

Total Monetary Impact of All Recommendations

Open: $ 0.00
Closed: $ 2,940.00

| 22-00066-184 | Summary | Report

Recommendations (7)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

The OIG made the following recommendation to the director of the VA Black Hills Health Care System: Ensure finance office staff conduct reviews on all inactive open obligations as required by VA Financial Policy, vol. 2, chap. 5, “Obligations Policy.”

No. 2   to Veterans Health Administration (VHA)

Establish procedures to ensure cardholders comply with processing requirements as stated in VA’s Financial Policy, vol. XVI, chap. 1B, “Government Purchase Card for Micro-Purchases.”

No. 3   to Veterans Health Administration (VHA)

Establish controls to confirm approving officials and purchase cardholders review their purchases and make sure contracting is used when it is in the best interest of the government.

No. 4   to Veterans Health Administration (VHA)

Develop measures to confirm that completed VA Form 0242 submissions are accurate and updated for all cardholders.

No. 5   to Veterans Health Administration (VHA)

Ensure the supply chain management staff implement a plan to monitor and correct unit conversion factor errors consistently and promptly to improve data reliability in the Generic Inventory Package.

No. 6   to Veterans Health Administration (VHA)

Develop and implement a plan to achieve an inventory turnover rate closer to the Veterans Health Administration-recommended level.

No. 7   to Veterans Health Administration (VHA)

Establish measures to improve compliance with the VHA directive to avoid end-of-year pharmaceutical purchases.

Total Monetary Impact of All Recommendations

Open: $ 0.00
Closed: $ 174,468.00

| 21-03853-174 | Summary | Report

Recommendations (8)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

Ensure that healthcare system finance office staff are made aware of policy requirements and that reviews are conducted on all inactive open obligations, and deobligate any identified excess funds as required by VA Financial Policy, vol. 2, chap. 5, “Obligations Policy.”

No. 2   to Veterans Health Administration (VHA)

Ensure cardholders comply with record retention requirements as stated in VA’s Financial Policy, vol. XVI, “Charge Card Programs.”

No. 3   to Veterans Health Administration (VHA)

Establish controls to confirm approving officials and purchase cardholders review their purchases and make sure contracting is used when it is in the best interest of the government.

No. 4   to Veterans Health Administration (VHA)

Require purchase cardholders to submit a request for ratification for any unauthorized commitments identified.

No. 5   to Veterans Health Administration (VHA)

Ensure quarterly purchase card audits are performed as required by the Veterans Health Administration’s standard operating procedure, “Internal Audits—Purchase Cards and Convenience Checks.”

No. 6   to Veterans Health Administration (VHA)

Ensure supply chain management staff implement a plan to improve data reliability within the Generic Inventory Package system.

No. 7   to Veterans Health Administration (VHA)

Ensure the chief of supply chain management signs quarterly physical inventory memorandums of “A” classified items and makes them available to Veterans Integrated Service Network personnel as required in the VHA’s Directive 1761 Supply Chain Management Operations.

No. 8   to Veterans Health Administration (VHA)

Develop and implement a plan to increase inventory turnover to meet the level recommended by the Veterans Health Administration Pharmacy Benefits Management Office.

Total Monetary Impact of All Recommendations

Open: $ 0.00
Closed: $ 379,439.00

| 21-02197-165 | Summary | Report

Recommendations (12)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

Ensure healthcare system finance office staff are made aware of policy requirements for open obligations and the responsible healthcare system finance office conducts reviews on all open obligations as required by VA Financial Policies and Procedures, Volume II, Chapter 5, “Obligations Policy,” October 2020.

No. 2   to Veterans Health Administration (VHA)

Establish procedures to ensure cardholders comply with record retention and transaction-processing requirements as stated in VA’s Financial Policy, vol. XVI, “Charge Card Program.”

No. 3   to Veterans Health Administration (VHA)

Develop a plan to work with the prime vendor to address having adequate stock to meet orders, reducing the need for the healthcare system to use nonprime vendors.

No. 4   to Veterans Health Administration (VHA)

Ensure the healthcare system follows the Medical Surgical Prime Vendor-Next Generation ordering hierarchy and purchases items from the Medical Surgical Prime Vendor-Next Generation contract before using other sources.

No. 5   to Veterans Health Administration (VHA)

Ensure the healthcare system elects and is granted a delivery method that meets just-in-time requirements.

No. 6   to Veterans Health Administration (VHA)

Ensure the healthcare system submits Medical Surgical Prime Vendor-Next Generation waiver requests and obtains approval before purchasing available formulary items from nonprime vendor sources.

No. 7   to Veterans Health Administration (VHA)

Ensure logistics staff and contracting officer’s representatives use all the tools available to inform the Medical Supplies Program Office and Strategic Acquisition Center of prime vendor performance issues.

No. 8   to Veterans Health Administration (VHA)

Develop formalized processes for achieving identified efficiency targets and use available pharmacy data to make business decisions.

No. 9   to Veterans Health Administration (VHA)

Educate non-VA providers on prescribing lower-cost drugs.

No. 10   to Veterans Health Administration (VHA)

Develop and implement a plan to increase inventory turnover to the Veterans Health Administration-recommended level.

No. 11   to Veterans Health Administration (VHA)

Develop and implement a plan to complete facility-based inventory audits of noncontrolled drug line items in compliance with Veterans Health Administration policy.

No. 12   to Veterans Health Administration (VHA)

Develop a plan to ensure that appropriate metrics for monitoring compliance with Veterans Health Administration policy are calculated correctly in the Pharmacy Benefits Management inventory reporting tool.

Total Monetary Impact of All Recommendations

Open: $ 0.00
Closed: $ 185,533.00

| 21-02458-94 | Summary | Report

Recommendations (10)Toggle Content


OpenClosed - ImplementedClosed - Not Implemented

No. 1   to Veterans Health Administration (VHA)

Ensure finance office staff are made aware of policy requirements and reviews are conducted on all inactive open obligations as required by VA Financial Policy, vol. 2, chap. 5, “Obligations Policy.”

No. 2   to Veterans Health Administration (VHA)

Ensure quarterly purchase card audits are performed as required by the Veterans Health Administration’s standard operating procedure, “Internal Audits—Purchase Cards and Convenience Checks.”

No. 3   to Veterans Health Administration (VHA)

Establish controls to confirm approving officials and purchase cardholders review their purchases and make sure contracting is used when it is in the best interest of the government.

No. 4   to Veterans Health Administration (VHA)

Require purchase cardholders to submit a request for ratification for any unauthorized commitments identified.

No. 5   to Veterans Health Administration (VHA)

Develop measures to confirm that completed VA Form 0242 submissions are accurate and updated for all cardholders.

No. 6   to Veterans Health Administration (VHA)

Ensure cardholders comply with record retention requirements as stated in VA’s Financial Policy, vol. 16, “Charge Card Programs.”

No. 7   to Veterans Health Administration (VHA)

Establish controls to make certain that budget or accounting staff review the salary cost data each pay period and promptly address cost center corrections with human resources staff as needed.

No. 8   to Veterans Health Administration (VHA)

Ensure service chiefs and supervisors review labor mapping for accuracy and completeness.

No. 9   to Veterans Health Administration (VHA)

Develop and implement a plan to increase inventory turnover closer to the VHA recommended level.

No. 10   to Veterans Health Administration (VHA)

Develop and implement a plan to complete facility based inventory audits of noncontrolled drug line items in compliance with VHA policy.

Total Monetary Impact of All Recommendations

Open: $ 0.00
Closed: $ 308,000.00

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