Veterans Community Care Program: VA should strengthen its ability to identify ineligible health care providers

Department of Veterans Affairs The Under Secretary of Health shall ensure that Community Care Network contractors perform automated monthly checks for all VCCP providers against the HHS OIG LEIE using SSN, date of birth and other unique identifiers. (Recommendation 1)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Under Secretary of Health should ensure that the VHA Office of Community Care identifies and implements a process to notify planners of specific HHS OIG LEIE waiver specifications. (Recommendation 2)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Under Secretary of Health should ensure that the VHA Office of Community Care revises its vendor exclusion standard operating procedures to require automated matching of vendors in PPMS with the SAM exclusions file using at the both the TIN and the NPI as identifiers. (Recommendation 3)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Under Secretary of Health should ensure that the VHA Office of Community Care consults with the GSA Administrator to correct technical issues to ensure that VHA can regularly monitor PPMS providers on the SAM Exclusions file. (Recommendation 4)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Under Secretary of Health is to ensure that the VHA Office of Community Care performs automated matching of the PPMS with the LEIE, SAM and NPPES in accordance with the monthly schedule outlined in its standard operating procedures. exclusion of suppliers. (Recommendation 5)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Undersecretary of Health should ensure that the VHA Office of Community Care identifies the inherent fraud risks associated with VCCP provider address checks. (Recommendation 6)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Undersecretary of Health should ensure that the VHA Office of Community Care assesses the likelihood and impact of inherent fraud risks associated with VCCP provider address checks. (Recommendation 7)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Under Secretary of Health should ensure that the VHA Office of Community Care determines the fraud risk tolerance related to VCCP provider address checks. (Recommendation 8)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Under Secretary of Health should ensure that the VHA Office of Community Care reviews the adequacy of existing fraud checks related to VCCP provider address checks. (Recommendation 9)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.

Department of Veterans Affairs The Under Secretary of Health should ensure that the VHA Community Care Office documents the fraud risk profile related to VCCP provider address checks. (Recommendation 10)

Once we have confirmed the actions taken by the agency in response to this recommendation, we will provide updated information.