Report Summary

Title: Financial Efficiency Review of the VA El Paso Healthcare System in Texas and New Mexico
Report Number: 21-02197-165 Download
Issue Date: 6/14/2022
VA Office: Veterans Health Administration (VHA)
Report Author: Office of Audits and Evaluations
Report Type: Financial Inspection
Release Type: Unrestricted

The VA Office of Inspector General (OIG) conducted this review to assess the oversight and stewardship of funds by the VA El Paso Healthcare System and to identify potential cost efficiencies in carrying out medical center functions. The review assessed the following financial activities and administrative processes to determine whether the healthcare system had appropriate oversight and controls in place: open obligations oversight, purchase card use, Medical/Surgical Prime Vendor-Next Generation (MSPV-NG) program use, and pharmacy operations.

The team identified several opportunities for improvement:

• The healthcare system did not perform required reviews for five of 10 inactive open obligations, totaling almost $3 million, risking funds not being used in the year they were appropriated, as required.

• The healthcare system did not always properly oversee purchase card transactions. Twenty-two of 38 sampled transactions contained errors that resulted in $159,000 in questioned costs. This occurred because cardholders did not adhere to VA policy on document retention.

• The healthcare system did not meet the goal to purchase 90 percent of formulary items from the MSPV-NG prime vendor, reaching only 14 percent on average. For 21 of 30 sampled purchase records, the review team questioned about $26,500 because the healthcare system did not submit national contract waiver requests, as required by VA policy.

• The healthcare system could improve pharmacy efficiency by narrowing the gap between observed drug costs and expected drug costs, bringing the turnover rates closer to the VHA recommended level, and meeting requirements for noncontrolled drug line audits.

The OIG made 12 recommendations to the VA El Paso Healthcare System director to use as a road map to improve financial operations. The recommendations address issues that, if left unattended, may eventually interfere with effective financial efficiency practices and the strong stewardship of VA resources.