Clipping 2, New Leader Same Problems Persist

Origins of the OIG and Concerns from the Beginning

The Office of the Inspector General (OIG) Report Number 8H1-A28-072, Date: February 17, 1998 continues our history lesson on the Veterans Health Administration by discussing its very own origins.  Just a reminder, OIG Report Number 8H1-A28-072 was prompted by the Senate Oversight Committee to look at the practicality/common sense of how programs were structured and managed.  It is important to note that the OIG was to keep both the VA secretary and the Senate Oversight Committee informed.

In 1978 Congress passed the "Inspector General Act of 1978," Public Law (P.L.) 95-452, which established an OIG in the Veterans Administration².

The OIG’s charter requires the creation of independent and objective units:

(1) to conduct and supervise audits and investigations relating to the

[Department’s] programs and operations;

(2) to provide leadership and coordination and recommend policies for

activities designed (A) to promote economy, efficiency, and effectiveness in the administration of, and (B) to prevent and detect fraud and abuse in,such programs and operations; and

(3) to provide a means for keeping the [Secretary] and the Congress fully

and currently informed about problems and deficiencies relating to the

administration of such programs and operations and the necessity for and

progress of corrective action³.

DM&S managers were concerned about the OIG's role in overseeing medical care

quality. In June 1980, Congressional hearings examined the OIG's capacity to

investigate health-related matters, as well as VA's proposed establishment of an

Office of Medical Inspector (OMI), which would report to VA's Chief Medical

Director (CMD). DM&S managers proposed that DM&S clinicians provided medical

care oversight through traditional peer reviews by health care professionals. The

CMD believed that, because of the CMD responsibilities outlined in Title 38, United

States Code, any efforts to oversee or evaluate quality of health care within DM&S

should be conducted under that authority⁴.

Congressional representatives and the General Accounting Office (GAO) expressed

concerns about maintaining independence and objectivity when oversight efforts

were governed within DM&S. At the same time, the OIG expressed concerns

about the burden of medical oversight responsibilities that might overwhelm the

already heavy OIG workload⁵.

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