Audit of VHA’s Consolidated Mail Outpatient Pharmacy Program

In September 2015, the Office of Inspector General received a congressional request to conduct an audit of the prescription processing and delivery timeliness for the Veterans Health Administration’s (VHA) Consolidated Mail Outpatient Pharmacy (CMOP) Program. VHA CMOPs had automated controls and pharmacists in place to ensure pharmaceuticals were secure and safely processed. However, at one of seven CMOPs, the Logistics Officer and Director or Associate Director did not review and approve inventory adjustments from the individual pill dispensing system as required by national policy. This occurred because the Director believed there was a minimal risk for theft and thus did not follow the policy. This CMOP had implemented these controls to minimize the risk for potential loss, theft, and diversion of pharmaceuticals. We determined that more than 99 percent of veterans received their prescription packages within this CMOP’s 10 day timeliness goal. This is calculated from the time the CMOP receives the prescription order to delivery of the package to the veteran. We also found that prescription-tracking information on VA’s My HealtheVet allowed veterans who are VA patients to access their prescription information and track prescriptions filled by CMOPs. Finally, the CMOP Program had quality metrics in place to monitor and address its performance. The Program met the core quality metrics during the period of July 1 through December 31, 2015. However, there were discrepancies with the accuracy of the data reported by the CMOPs to the National Office. We recommended the Under Secretary for Health ensure the CMOP Logistics Officer and Director or Associate Director review and sign all inventory adjustment documentation monthly and the CMOP National Office implement a mechanism to validate self reported data to help ensure the reliability of its core quality metrics. The Under Secretary for Health concurred with our findings and requested closure of the recommendations, based upon the actions taken as a result of our audit. The documentation provided was sufficient to close the recommendations.