OIG Reports

No. 1   to Office of Management

Ensure that Veterans Health Administration fiscal staff are trained on VA financial policy requirements for the preparation and approval of journal vouchers (including expenditure transfers).

No. 1   to Office of Acquisitions, Logistics, and Construction (OALC)

Issue guidance clarifying that allergens are exempt from the public law and include how the determination was reached.

No. 2   to Office of Acquisitions, Logistics, and Construction (OALC)

Formalize and communicate the process for manufacturers to request exemptions.

No. 3   to Office of Acquisitions, Logistics, and Construction (OALC)

Formalize the internal process for granting exemptions.

No. 4   to Office of Acquisitions, Logistics, and Construction (OALC)

Establish a procedure for monitoring covered drugs identified in this report as not commercially sold.

No. 5   to Office of Acquisitions, Logistics, and Construction (OALC)

Develop a procedure to monitor covered drugs identified in this report as newly launched to ensure they have an established ceiling price, and make certain they are made available on the Federal Supply Schedule at the end of the 75-day period.

No. 6   to Office of Acquisitions, Logistics, and Construction (OALC)

Request that noncompliant manufacturers identified by the Office of Inspector General conduct a self-audit and submit their findings for remediation.

No. 7   to Office of Acquisitions, Logistics, and Construction (OALC)

Engage with the Food and Drug Administration to ensure that when manufacturers request new national drug codes, they are made aware of the public law requirements.

No. 8   to Office of Acquisitions, Logistics, and Construction (OALC)

Require contracting staff at the National Acquisition Center to conduct a covered drug check for all of a manufacturer’s drugs when any pharmaceutical Federal Supply Schedule proposal or product addition modification is submitted.

No. 1   to Veterans Health Administration (VHA)

The under secretary for health to make sure all scheduling guidance and other materials correctly refer to the date that should be used to determine wait-time eligibility for community care.

No. 2   to Veterans Health Administration (VHA)

The under secretary for health to make sure the Office of Integrated Veteran Care provides ongoing oversight to ensure all facilities are using nationally approved scheduling tools.

No. 3   to Veterans Health Administration (VHA)

The under secretary for health to develop an oversight process to verify that schedulers are using the correct dates to calculate wait-time eligibility for community care.

No. 4   to Veterans Health Administration (VHA)

The under secretary for health to develop a mechanism to notify schedulers when it is appropriate to consider wait-time eligibility for community care regardless of which scheduling system schedulers are using.

No. 1   to Veterans Health Administration (VHA)

Require the Office of Regulations, Appeals, and Policy, in coordination with the Office of General Counsel, to determine whether the Office of Dentistry and the Consolidated Patient Account Center Program have appealable benefits decisions governed by the AMA, and if so, to update program policies, processes, and procedures accordingly, including ensuring that claimants receive written decision notices that meet all act requirements.

No. 2   to Veterans Health Administration (VHA)

Require the Office of Regulations, Appeals, and Policy to evaluate the program offices’ barriers to including all required elements in decision notices and take corrective action, seeking congressional relief if needed.

No. 3   to Veterans Health Administration (VHA)

Using the evaluation findings from recommendation 2, require Payment Operations to update its systems to generate AMA-compliant decision notices to the extent possible.

No. 4   to Veterans Health Administration (VHA)

Using the same evaluation findings, require the Veteran and Family Member Programs to update its systems to generate AMA-compliant decision notices to the extent possible.

No. 5   to Veterans Health Administration (VHA)

Require the Office of Regulations, Appeals, and Policy and the program office for Member Services’ Eligibility and Enrollment Division to ensure that priority group assignment decision notices are provided with enrollment handbooks given to veterans.

No. 6   to Veterans Health Administration (VHA)

Identify resources and assign duties to conduct quality control reviews of decision letters with program offices to remediate deficiencies.

No. 7   to Veterans Health Administration (VHA)

Work with the Office of Information and Technology to update Caseflow to address identified VHA system requirements within specified deadlines, including adding a program identifier and facilitating entries for individuals and entities that are not veterans.

No. 8   to Veterans Health Administration (VHA)

Establish interim tracking procedures with the program offices until Caseflow can be considered a reliable system for VHA oversight.

No. 9   to Veterans Health Administration (VHA)

In coordination with the Office of General Counsel, seek clarification on how the reporting metrics sections of the Appeals Modernization Act apply to VHA, and then develop those measures.

No. 10   to Veterans Health Administration (VHA)

Issue policy and other clear guidance that includes standard tracking processes and procedures, and oversight of that tracking.

No. 11   to Veterans Health Administration (VHA)

Work with VBA and others to allow access to all VHA program offices, and ensure that those offices in turn require that staff use the Centralized Mail Portal for all decision reviews or establish another mechanism that ensures all decision reviews are tracked from request receipt through routing and processing.

No. 12   to Veterans Health Administration (VHA)

Work with the Office of Information and Technology to determine the best way to create a central repository and identify the necessary resources to implement and maintain it.

No. 13   to Veterans Health Administration (VHA)

Develop decision review retention standards and communicate to the relevant programs what types of claims and appeals documentation should be stored, for how long, and where.

No. 14   to Veterans Health Administration (VHA)

Implement training on processing and tracking appeals that is mandatory for VHA staff who process decision reviews.

No. 1   to Veterans Benefits Administration (VBA)

The under secretary for benefits update the instructions provided to examiners for completing Gulf War general medical examinations to add the definitional requirements for medically unexplained illness as outlined in 38 C.F.R.§ 3.317 and clarify the instructions and related procedures to reflect that an examiner’s determination that a disability pattern is an undiagnosed illness or a medically unexplained illness requires a written explanation.

No. 2   to Veterans Benefits Administration (VBA)

The under secretary for benefits implement a plan to update the Gulf War general medical examination disability benefits questionnaire to add the definitional requirements for medically unexplained illness as outlined in 38 C.F.R.§ 3.317.

No. 3   to Veterans Benefits Administration (VBA)

The under secretary for benefits implement a plan to incorporate into the Gulf War general medical disability benefits questionnaires the clinical requirements listed in 38 C.F.R.§ 3.317 for an undiagnosed illness and a medically unexplained illness.

No. 4   to Veterans Benefits Administration (VBA)

The under secretary for benefits implement a plan to incorporate into the appropriate medical disability benefits questionnaires the diagnostic criteria for functional gastrointestinal disorders from 38 C.F.R.§ 3.317 and require examiners to provide an explanation of whether the disorder is functional or structural. This should include a requirement that any necessary testing has been completed before examiners diagnose specific functional gastrointestinal disorders.

No. 5   to Veterans Benefits Administration (VBA)

The under secretary for benefits update VA’s Adjudication Procedures Manual to clearly state that all the requirements of 38 C.F.R.§ 3.317 must be met to award benefits. Clarify and reiterate instructions to claims processors that benefits should only be awarded after taking into consideration the overall evidence of record.

No. 1   to Veterans Benefits Administration (VBA)

Conduct national refresher training on the Electronic Health Record Modernization National Process Memorandum and assess training effectiveness

No. 2   to Veterans Benefits Administration (VBA)

Consider updating VA Manual 21-4 to reflect that quality assurance measures include addressing failures to consider all Veterans Health Administration records as directed in the Adjudication Procedures Manual that are subject to an enterprise-wide search in the Compensation and Pension Records Interchange system whether or not directed to those records by the claimant and ensure staff are advised of the changes.

No. 1   to Veterans Benefits Administration (VBA)

The Pension and Fiduciary Service clarifies procedural requirements to fiduciary hub staff on how to verify whether VA-derived funds of deceased beneficiaries must be returned to VA, including whether the fiduciary identified any valid will or heir to whom the funds are otherwise due.

No. 2   to Veterans Benefits Administration (VBA)

The Pension and Fiduciary Service considers reimplementing the procedural requirement to verify the disbursement of VA-derived funds to deceased beneficiaries’ estates when a valid will or heir exists.

No. 3   to Veterans Benefits Administration (VBA)

The Pension and Fiduciary Service identifies existing or implements new electronic controls that allow VBA staff to track Fiduciary Program tasks, timeliness, and workload related to the return of deceased beneficiaries’ VA-derived funds to VA that would otherwise escheat to a state if not disbursed to heirs.

No. 4   to Veterans Benefits Administration (VBA)

The Pension and Fiduciary Service and the Office of Field Operations establish a methodology and monitor workload to ensure the prompt return of deceased beneficiaries’ VA-derived funds.