Assignment of Hotline Cases and Results

Pie chart depicting percentage of cases reviewed by OIG Offices

Hotline Cases Reviewed by OIG

A Pie Chart Representing the percentage of Hotline cases reviewed by OIG offices in FY 2012:

  • Criminal Allegations 81%
  • Healthcare Concerns 14%
  • Administrative Issues 5%

Out of the 27,000 Hotline contacts received annually, the Hotline refers approximately 2,000 of the most serious Hotline complaints to OIG reviewers for consideration. These referrals resulted in approximately 480 internal OIG cases in FY 2012. Most Hotline cases reviewed by the OIG are based on allegations of criminal wrongdoing likely to result in prosecution. The second largest group of cases reviewed by the OIG are based on patient safety and systemic healthcare issues. The results of the latest OIG Hotline work are included in the OIG’s Semiannual Reports to Congress:

Pie chart depicting percentage of cases reviewed by VA Management

A Pie Chart Representing the percentage of Hotline cases reviewed by VA Management:

  • Veterans Health Administration 60%
  • Veterans Venefits Administration 33%
  • Other VA Offices 8%

Hotline Cases Reviewed by VA Management

In addition to Hotline cases completed by OIG reviewers, another 740 cases were referred in FY 2012 to VA management for review and response to the Hotline. VHA reviewed 60 percent of external Hotline cases, and VBA reviewed 33 percent. The OIG evaluated the adequacy of these VA reviews prior to case closure. VA reviewers substantiated 40 percent of Hotline cases closed in FY 2012. Closed Hotline cases reviewed by VA produced a total of 579 administrative and corrective actions and $6.5 million in monetary benefits in FY 2012. The Hotline directs complaints not resulting in cases back to VA management either directly or by providing the complainant the location of a VA organization to address their concerns.

The following are examples of recent Hotline cases substantiated as a result of external reviews:

Review of Allegations Results in Security Improvements at Puget Sound HCS

The VA Office of Security and Law Enforcement reviewed hotline allegations concerning the Police Service at the VA Puget Sound HCS, Seattle, WA. Office of Security and Law Enforcement agents substantiated problems related to radio equipment, facility alarms, law enforcement information systems, police procedures, and staffing. As a result, they made numerous recommendations to improve the security of Veterans, family members, and staff on System campuses.

VBA Delays Reviewing Initial Post-9/11 GI Bill School Transactions

A complainant reported that during FY 2012, VBA suspended retroactive Post-9/11 GI Bill school compliance surveys for the 2009-2010 academic year, which was the first year VBA began making payments to students and schools under the new program. At that time, VBA was using a software system that required claims examiners to perform extensive manual actions, such as transferring or calculating data, which increased the risk that processing errors would occur. For example, a VBA survey at a Colorado university found school errors in 819 (62 percent) of the 1,319 students' records reviewed. The complaint alleged that suspending the reviews would result in undetected overpayments or underpayments. VBA's response indicated that the scope of its surveys was reduced in FY 2012 to focus on for-profit schools, but that review of 2009-2010 enrollments would resume in FY 2013.

VA Ends Leases for Unused Information Technology Centers

As a result of a Hotline contact, the Office of Information and Technology (OIT) terminated two leases originated in FY 2010 for unused data storage centers in Pennsylvania and Colorado. OIT planned to store electronic medical records in both locations as part of its National Data Center Consolidation Program. However, in FY 2011, VA elected to shift planned data storage to DoD facilities in Missouri and Georgia as part of the VA-DoD joint Integrated Electronic Health Record initiative. The inconsistent data storage strategies pursued by OIT resulted in VA paying $3.7 million for the unused centers.

Inadequate Advanced Planning Threatens VISN 18 Patient Care Procurements

The VA Southwest Health Care Network, Mesa, AZ, concluded that during FY 2011, many contracts affecting the continuity of patient care had expired or would have expired without urgent interventions. Network officials said this occurred because program offices did not submit their requirements on a timely basis or submitted inadequately supported requests for limiting competition. To address these problems, the VISN provided additional training to responsible program officials.

VARO Reduces Compensation for Incarcerated Veteran Following Hotline Tip

The results of a Seattle, WA, VARO review found that a service-connected Veteran continued to receive full compensation payments during his incarceration. As a result of the improper payments, the VARO took action to reduce the Veteran’s compensation, which resulted in a cost savings of $51,000 over a 3-year period.

Hotline Complainants Help End Improper Payments to Ineligible Beneficiaries

A review conducted by the Philadelphia, PA, VARO and Insurance Center found that a claimant concealed a common-law marriage in effect since 1999 in order to improperly continue receiving DIC benefits awarded based on a previous marriage to a Veteran. The case resulted in savings of $229,911, including the avoidance of 5 years of additional benefits the claimant would have received had the complainant not disclosed the impropriety. In a similar case, a review conducted by the St. Paul, MN, VARO found that another claimant, who remarried in 2003, continued to receive DIC benefits improperly because the claimant failed to notify VA of the remarriage. The case resulted in a savings of $181,456 over a 5-year period.

VHA Employee Caught Moonlighting During Official VA Tour of Duty

A review conducted by the VA Central California HCS, Fresno, CA, found that between January 2009 and March 2012, an employee misused official time to perform remunerated teaching duties for a non-VA employer. The HCS estimated that the misused official time was valued at $17,802. As a corrective action, the HCS reported the employee retroactively used 384 hours of annual leave.