TriWest Healthcare Alliance Corp. Agrees to Pay $179.7 Million to Resolve Overpayments from the Department of Veterans Affairs

WASHINGTON –   TriWest Healthcare Alliance Corp. has agreed to pay the United States $179,700,000 to resolve claims that it received overpayments from the U.S. Department of Veterans Affairs (VA) in connection with its administration of certain VA health care programs, the Department of Justice announced today.

TriWest, an Arizona corporation headquartered in Phoenix, is in the business of administering government health care programs, including those operated by the VA. TriWest is responsible for administering certain portions of the VA Patient-Centered Community Care Program (PC3) and the VA’s former Veterans Choice Program (Choice). Both programs have enabled veterans to obtain medical care from providers in their communities. As an administrator of these programs, TriWest is paid by the VA to coordinate medical appointments and make payments to health care providers. 

The settlement resolves allegations that TriWest retained overpayments from the VA in connection with its administration of the PC3 and Choice Programs. The alleged overpayments included payments by the VA to TriWest twice for the same services as well as payments for services for which TriWest received full or partial reimbursement from certain health care providers.

“The VA’s PC3 and Choice Programs have provided significant benefits to our nation’s veterans,” said Acting Assistant Attorney General Jeffrey Bossert Clark of the Justice Department’s Civil Division. “The department will continue to support the VA and its Office of Inspector General in ensuring that the VA’s programs are administered properly and that taxpayer funds are used as intended.”

“The VA provides invaluable assistance to those who have sacrificed on our behalf,” said U.S. Attorney Michael Bailey for the District of Arizona. “It is vital that those who administer programs for the VA be held accountable to do so with the utmost care and integrity.”

“The VA Office of Inspector General works tirelessly to promote the economy, efficiency, and integrity of the VA’s programs and operations,” said VA Inspector General Michael J. Missal. “This settlement is integral to ensuring that the VA’s funds are spent for the benefit of our nation’s veterans. I appreciate the teamwork and dedication that led to this significant recovery.”

The settlement was the result of a coordinated effort by the U.S. Attorney’s Office for the District of Arizona, the Department of Justice Civil Division’s Commercial Litigation Branch, and the VA and its Office of Inspector General. The claims resolved by the settlement agreement are allegations only, and there has been no determination of liability.    

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    Since fiscal year 2016, the Centers for Medicare & Medicaid Services (CMS) has initiated 49 financial management reviews (FMR) to examine state Medicaid agencies' compliance with a variety of federal policies. These 49 FMRs frequently found one or more instances of states' non-compliance. CMS identified instances of non-compliance that had a financial impact totaling about $358 million. CMS identified internal control weaknesses and directed states to make changes to their Medicaid policies. However, FMRs have not always examined topics or states that reflect the areas of highest expenditures. In 2018, GAO recommended that CMS improve its targeting of oversight resources. CMS agreed with this recommendation, but has not yet implemented it. In addition, CMS guidance generally expects draft FMR reports to be completed in the year they began. However, two-thirds of FMRs (26 of 39) initiated in fiscal years 2016 to 2019 were still under review in June 2020, which can delay state actions to address program vulnerabilities. CMS officials said that at least five states would not take actions—such as returning federal funds for unallowable expenditures—until they received a complete report. Status of Financial Management Reviews (FMR) Initiated in Fiscal Years 2016 to 2019, as of June 2020 CMS officials cited competing priorities, decreased staff, and the agency's review process—which involves multiple steps and levels of review—as factors affecting their use of FMRs for oversight. CMS took steps during the course of GAO's review to complete FMRs that had been under review for several years. The agency has not established time frames for the completion of individual review steps or for its overall review of FMR reports. Developing and implementing such time frames would provide a tool to help monitor CMS's progress in completing FMRs and ensure prompt action on FMR findings. Over the last two decades, Medicaid—a joint, federal-state health care financing program for low-income and medically needy individuals—more than tripled in expenditures and doubled in enrollment. CMS estimates the program will continue to grow, exceeding $1 trillion in expenditures and 81 million enrollees in 2028. The size and growth of Medicaid present oversight challenges. CMS is responsible for assuring that states' Medicaid expenditures comply with federal requirements, and FMRs are one of its financial oversight tools. CMS generally directs its regional offices to conduct one focused FMR each year on an area of high risk within their regions, typically within one state. GAO was asked to examine CMS's use of FMRs. In this report, GAO examines the extent to which CMS has used FMRs to oversee state Medicaid programs. GAO reviewed CMS documentation on FMR findings and their status, and resources assigned to FMRs and other financial review functions. GAO also interviewed CMS officials from all 10 regional offices and the central office, and assessed CMS's FMR policies and procedures against federal internal control standards. CMS should develop and implement time frames to ensure the timely completion of FMRs. The Department of Health and Human Services concurred with our recommendation. For more information, contact Carolyn L. Yocom at (202) 512-7114 or yocomc@gao.gov.
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  • Chemical Security: Overlapping Programs Could Better Collaborate to Share Information and Identify Potential Security Gaps
    In U.S GAO News
    Eight federal programs addressing chemical safety or security from four departments or agencies that GAO reviewed contain requirements or guidance that generally align with at least half of the Department of Homeland Security's (DHS) 18 Chemical Facility Anti-Terrorism Standards (CFATS) program standards. At least 550 of 3,300 (16 percent) facilities subject to the CFATS program are also subject to other federal programs. Analyses of CFATS and these eight programs indicate that some overlap, duplication, and fragmentation exists, depending on the program or programs to which a facility is subject. For example, six federal programs' requirements or guidance indicate some duplication with CFATS. CFATS program officials acknowledge similarities among these programs' requirements or guidance, some of which are duplicative, and said that the CFATS program allows facilities to meet CFATS program standards by providing information they prepared for other programs. more than 1,600 public water systems or wastewater treatment facilities are excluded under the CFATS statute, leading to fragmentation. While such facilities are subject to other programs, those programs collectively do not contain requirements or guidance that align with four CFATS standards. According to DHS, public water systems and wastewater treatment facilities are frequently subject to safety regulations that may have some security value, but in most cases, these facilities are not required to implement security measures commensurate to their level of security risk, which may lead to potential security gaps. The departments and agencies responsible for all nine of these chemical safety and security programs—four of which are managed by DHS, three by the Environmental Protection Agency (EPA), and one each managed by the Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF) and the Department of Transportation (DOT)—have previously worked together to enhance information collection and sharing in response to Executive Order 13650, issued in 2013. This Executive Order directed these programs to take actions related to improving federal agency coordination and information sharing. However, these programs have not identified which facilities are subject to multiple programs, such that facilities may be unnecessarily developing duplicative information to comply with multiple programs. Although CFATS allows facilities to use information they prepared for other programs, CFATS program guidance does not specify what information facilities can reuse. Finally, DHS and EPA leaders acknowledged that there are differences between CFATS requirements and the security requirements for public water systems and wastewater treatment facilities, but they have not assessed the extent to which potential security gaps may exist. By leveraging collaboration established through the existing Executive Order working group, the CFATS program and chemical safety and security partners would be better positioned to minimize unnecessary duplication between CFATS and other programs and better ensure the security of facilities currently subject to fragmented requirements. Facilities with hazardous chemicals could be targeted by terrorists to inflict mass casualties or damage. Federal regulations applicable to chemical safety and security have evolved over time as authorizing statutes and regulations established programs for different purposes, such as safety versus security, and with different enforcement authorities. GAO has reported that such programs may be able to achieve greater efficiency where overlap exists by reducing duplication and better managing fragmentation. GAO was asked to review issues related to the effects that overlap, duplication, and fragmentation among the multiple federal programs may have on the security of the chemical sector. This report addresses the extent to which (1) such issues may exist between CFATS and other federal programs, and (2) the CFATS program collaborates with other federal programs. GAO analyzed the most recent available data on facilities subject to nine programs from DHS, EPA, ATF, and DOT; reviewed and analyzed statutes, regulations, and program guidance; and interviewed agency officials. GAO is making seven recommendations, including that DHS, EPA, ATF, and DOT identify facilities subject to multiple programs; DHS clarify guidance; and DHS and EPA assess security gaps. Agencies generally agreed with six; EPA did not agree with the recommendation on gaps. GAO continues to believe it is valid, as discussed in the report. For more information, contact Nathan Anderson at (206) 287-4804 or AndersonN@gao.gov.
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    In Crime News
    A U.S. accountant was sentenced in the Southern District of New York to 39 months in prison for wire fraud, tax fraud, money laundering, aggravated identity theft, and other charges, announced Acting Assistant Attorney General Brian C. Rabbitt and Acting U.S. Attorney Audrey Strauss of the Southern District of New York.
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    The Justice Department today filed a lawsuit against the Village of Hinsdale, Illinois, alleging disability discrimination in violation of the Fair Housing Act.  
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  • Federal Contractor Agrees to Pay $18.98 Million for Alleged False Claims Act Caused by Overcharges and Unqualified Labor
    In Crime News
    Cognosante LLC has agreed to pay the United States $18,987,789 to resolve allegations that it violated the False Claims Act by using unqualified labor and overcharging the United States for services provided to government agencies under two General Services Administration (GSA) contracts, the Justice Department announced today.  Cognosante, which is headquartered in Falls Church, Virginia, provides health care and IT services and solutions to federal agencies.   
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    In Crime News
    Three individuals have been charged today for their alleged roles in the Twitter hack that occurred on July 15, 2020.
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    In Crime News
    A Colorado resident was sentenced to 15 months in prison yesterday for his role in a biodiesel tax credit fraud scheme, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division.
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    A federal grand jury in the District of Puerto Rico returned a 13-count indictment against legislator María Milagros Charbonier-Laureano (Charbonier), aka “Tata,” a member of the Puerto Rico House of Representatives, as well as her husband Orlando Montes-Rivera (Montes), their son Orlando Gabriel Montes-Charbonier, and her assistant Frances Acevedo-Ceballos (Acevedo), for their alleged participation in a years-long theft, bribery, and kickback conspiracy.
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    In Crime News
    The Bank of Nova Scotia (Scotiabank), a Toronto, Canada-based global banking and financial services firm, has entered into a resolution with the Department of Justice to resolve criminal charges related to a price manipulation scheme involving thousands of episodes of unlawful trading activity by four traders in the precious metals futures contracts markets.
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  • Veterans Community Care Program: Improvements Needed to Help Ensure Timely Access to Care
    In U.S GAO News
    In a September 2020 report, GAO found that the Department of Veterans Affairs (VA) established an appointment scheduling process for its new Veterans Community Care Program (VCCP) but did not specify allowable wait times for some key steps in the process. Further, GAO found that VA had not established an overall wait-time performance measure—that is, the maximum amount of time it should take for veterans to receive care from community providers. In 2013, GAO recommended that VA establish a wait-time measure under a prior VA community care program, and in 2018 again recommended that VA establish an achievable wait-time goal to receive care under the VCCP. VA has not implemented these recommendations. Potential Allowable Wait Time to Obtain Care through the Veterans Community Care Program Note: This figure illustrates potential allowable wait times in calendar days for eligible veterans who are referred to the Veterans Community Care Program through routine referrals (not urgent), and have VA medical center staff—Referral Coordination Team (RCT) and community care staff (CC staff)—schedule the appointments on their behalf. Given VA's lack of action over the prior 7 years in implementing wait-time measures for various community care programs, GAO believes that Congressional action is warranted requiring VA to establish such an overall measure for the VCCP. This should help to achieve timely health care for veterans. GAO found additional VCCP challenges needing VA action: (1) VA uses metrics that are remnants from the previous community care program and inconsistent with the time frames established in the VCCP scheduling process. (2) Few community providers have signed up to use the software VA intends for VA medical center (VAMC) staff and community providers to use to electronically share referral information with each other. (3) Select VAMCs faced challenges scheduling appointments in a timely manner and most did not have the full amount of community care staff VA's staffing tool recommended. In June 2019, VA implemented its new community care program, the VCCP, as required by the VA MISSION Act of 2018. This new program replaced or consolidated prior community care programs. Under the VCCP, VAMC staff are responsible for community care appointment scheduling. This statement summarizes GAO's September 2020 report. It describes for the VCCP: (1) the appointment scheduling process that VA established for veterans, (2) the metrics VA used to monitor the timeliness of appointment scheduling, (3) VA's efforts to prepare VAMC staff for appointment scheduling, and (4) VA's efforts to determine VAMC staffing needs. In performing that work, GAO reviewed VA documentation, such as guidance, referral timeliness data, and VAMC community care staffing data; conducted site visits to five VAMCs; and interviewed VA and VAMC officials. In its September 2020 report, GAO recommended that Congress consider requiring VA to establish an overall wait-time measure for the VCCP. GAO also made three recommendations to VA, including that it align its monitoring metrics with the VCCP appointment scheduling process. VA did not concur with this recommendation, but concurred with the other two. GAO maintains that all recommendations are warranted. For more information, contact Sharon M. Silas at (202) 512-7114 or silass@gao.gov.
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  • Owner of Michigan Payroll Tax Services Firm Charged With Employment Tax Fraud
    In Crime News
    A federal grand jury in Detroit, Michigan, returned an indictment today charging a Farwell, Michigan, businessman with failing to pay payroll taxes to the Internal Revenue Service (IRS) and failing to file his own returns, announced Principal Deputy Assistant Attorney General Richard E. Zuckerman of the Justice Department’s Tax Division and U.S. Attorney Matthew Schneider for the Eastern District of Michigan.
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