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Inadequate Oversight of the Medical/Surgical Prime Vendor Program’s Order Fulfillment and Performance Reporting for Eastern Area Medical Centers

Report Information

Issue Date
Report Number
17-03718-240
VA Office
Veterans Health Administration (VHA)
Acquisitions, Logistics, and Construction (OALC)
Report Author
Office of Audits and Evaluations
Report Type
Audit
Recommendations
11
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
The VA Office of Inspector General (OIG) conducted this audit to determine if VA effectively monitored Medical/Surgical Prime Vendor-Next Generation Program (MSPV-NG) order fulfillment and vendor performance. This audit focused on VA medical centers serviced by American Medical Depot (AMD). MSPV-NG is VA’s national program for obtaining medical or surgical supplies across the Veterans Health Administration (VHA). The audit team reviewed a sample of AMD’s delivery orders and estimated that medical centers received incorrect orders about 60 percent of the time. Incorrect orders occurred when delivery orders and invoice pricing did not match approved costs, products were obtained from unapproved suppliers, or staff obligated funds without proper authority. When necessary supplies are unavailable or incorrect because of vendors’ errors, veterans’ quality of care could be at risk. Orders were incorrect because VHA’s Healthcare Commodities Program Office and VA’s Strategic Acquisition Center did not develop a formal process to validate prime vendor performance reporting and the algorithm used by AMD. In addition, contracting officer representative (COR) positions at four of eight VA medical centers were vacant. CORs are responsible for monitoring vendor accuracy and performance. As a result, VA did not verify AMD’s self reported compliance with performance measures. The audit team found that AMD did not use the calculations and methodologies required by its contract, which led to inaccurate reporting. AMD also used unapproved suppliers. In addition, deliveries and invoice pricing did not match approved product costs, causing improper payments. The audit team estimated that, without correction, VA would improperly pay AMD about $84 million over the next five years. The OIG made 11 recommendations to VA including establishing measures to ensure vendor compliance with contract requirements and developing and implementing processes to validate vendor performance and reporting.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, office of acquisition, logistics, and construction, require the Healthcare Commodities Program Office and Strategic Acquisition Center to develop a formal process to validate correct order fulfillment reporting by the prime vendors, ensure the correct algorithms are used, and help prevent missed opportunities to identify and mitigate issues.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, requires the Healthcare Commodities Program Office to ensure Medical/Surgical Prime Vendor Next Generation contracting officer’s representatives get timely access to the performance metric reporting, such as reporting on correct order fulfillment.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, office of acquisition, logistics, and construction, require the Healthcare Commodities Program Office and Strategic Acquisition Center to monitor contracting officer’s representatives to ensure performance metric reporting is reviewed for accuracy.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, office of acquisition, logistics, and construction, require the Healthcare Commodities Program Office and Strategic Acquisition Center to strengthen processes and procedures so that staff use the Medical/Surgical Prime Vendor Next Generation formulary to change unit of issuance and product pricing information in the item master files.
No. 5
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, office of acquisition, logistics, and construction, require the Healthcare Commodities Program Office and Strategic Acquisition Center to confirm that prime vendor American Medical Depot uses formulary sources when fulfilling requests for medical or surgical products under the Medical/Surgical Prime Vendor Next Generation.
No. 6
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, requires the director, VHA Procurement and Logistics Office, to see that all those who order supplies under the Medical/Surgical Prime Vendor-Next Generation contract have proper delegated authority.
No. 7
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, Office of Acquisition, Logistics, and Construction, require the Healthcare Commodities Program Office and Strategic Acquisition Center to monitor the Integrated Product Team’s development and implementation of a process to validate performance metric reporting such as on unadjusted fill rates.
No. 8
Open Recommendation Image, Square
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, requires the Procurement and Logistics Office to strengthen controls, monitor the Healthcare Commodities Program Office monthly, and ensure adherence to the established Medical/Surgical Prime Vendor Next Generation program control plan.
No. 9
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, Office of Acquisition, Logistics, and Construction, require the Healthcare Commodities Program Office and Strategic Acquisition Center to identify and resolve discrepancies between unadjusted fill rate reporting methods used by the Medical/Surgical Prime Vendor Next Generation prime vendor for select eastern area VA medical centers.
No. 10
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, office of acquisition, logistics, and construction, direct the Healthcare Commodities Program Office and Strategic Acquisition Center to see that all prime vendors use the unadjusted fill rate calculation methodology in accordance with the Medical/Surgical Prime Vendor Next Generation contract.
No. 11
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The executive in charge, office of under secretary for health, and the principal executive director, office of acquisition, logistics, and construction, instruct the Healthcare Commodities Program Office and Strategic Acquisition Center to require the Medical/Surgical Prime Vendor Next Generation prime vendor for select eastern area VA medical centers to provide corrected unadjusted fill rates for the fiscal year 2018 and current reporting periods.
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 84,000,000.00