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VETERANS’ HEALTH CARE - Preliminary Observations on VHA’s Claims Processing Delays and Efforts to Improve the Timeliness of Payments to Community Providers
Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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Due to increases in expenditures and utilization of VA care in the community services in recent years, VHA has had difficulty processing claims in a timely manner. In planning to consolidate its ... /> This statement, which is based on ongoing work, summarizes GAO’s preliminary observations about (1) VHA’s, Medicare’s, and TRICARE’s claims processing timeliness in fiscal year 2015; (2) factors that have impeded ... VHA’s timeliness in processing claims; (3) community providers’ experiences; and (4) VHA’s recent actions and plans to improve its claims processing and payment timeliness. To conduct its ongoing work ... Data processing hold back by technology limitation, workload and administrative burden ... US GAO analyzed all factors of slower processing and user unfriendliness that occur sometimes to the veterans healthcare. The main focus is data processing - and it has been proved that it can ... be failing not only because of technology, but also because of work-process design, staff and organisation.
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General Accountability Office
, issued in 2016
Risk cases: 6
The Shared Services Centre
The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The necessary environment for the efficient management of the Shared Service Center is lacking The department's administration of the Shared Services Centre (SSC) has been effective for sharing resources between the departments and delivering selected back-office services to a small client base. However, the governance arrangements established to oversight the SSC have not positioned it well for the future and the departments have not yet determined if the arrangement is efficient and resulting in savings. ANAO found instances where the advisory board of SSC was not consulted or involved in decisions relating to the strategic direction, financial arrangements and expenditure priorities. Information reported to the board did not focus on areas of strategic importance and the quality and completeness of this information could be improved. The mechanisms established for setting out responsibilities and obligations and ensuring transparency for services delivered by the SSC was weak. Service standards and levels were not fixed and can change. The delineation of responsibilities between the SSC and its clients was not clear and there was no commitment by the SSC to certify the quality of its control framework.
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The Australian National Audit Office
, issued in 2016
Risk cases: 2
Management of IT security in systems outsourced to external suppliers
Security to be improved in IT processes outsourced to external suppliers When IT processes are outsourced to external suppliers, the authorities no longer have direct control of the IT security, but remain responsible for managing the security of the IT. Authorities that fail to manage IT security actively based on risk assessments, and omit to monitor the implementation of these requirements, will not be able to determine if the level of IT security in the outsourced systems safeguards their systems and data. This is how the conclusion of the Rigsrevisionen starts. The Danish auditors noticed improvement in the audited entities, but they add that tha majority of the auditees: can refine their requirements for and follow-up on access control and logging practices
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Security to be improved in IT processes outsourced to external suppliers When IT processes are outsourced to external suppliers, the authorities no longer have direct control of the IT security, but remain responsible for managing the security of the IT. Authorities that fail to manage IT security actively based on risk assessments, and omit to monitor the implementation of these requirements, will not be able to determine if the level of IT security in the outsourced systems safeguards their systems and data. This is how the conclusion of the Rigsrevisionen starts. The Danish auditors noticed improvement in the audited entities, but they add that tha majority of the auditees: can refine their requirements for and follow-up on access control and logging practices
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National Audit Office of Denmark
, issued in 2016
Risk cases: 3
Management of Information Resources of the Ministry of the Interior
Many activities of the Ministry of the Interior require the use of information resources that are of great significance to the entire State, such as the state and departmental registers, and public ... information systems. Whereas the Ministry has failed to implement some of the public audit recommendations of 2007 and 2010,6 we analysed, whether there have been any positive changes in the field of IT ... management. Their impact is important not only because the Ministry manages 16 information resources, which ensure data availability to the population, efficient activity of the services, and operation ... ... Process maturity examination can help in IT audit ... also flaws in change management and security processes. But the finding, which gave them the key to the root cause of problems, was connected with maturity assessment of the auditee's IT processes. ... Main risk areas in case of this audit were strategic and organisational - Ministry’s weak ownership of IT resources, insufficient audit and internal control function. SAI Lithuania auditors found
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Many activities of the Ministry of the Interior require the use of information resources that are of great significance to the entire State, such as the state and departmental registers, and public ... information systems. Whereas the Ministry has failed to implement some of the public audit recommendations of 2007 and 2010,6 we analysed, whether there have been any positive changes in the field of IT ... management. Their impact is important not only because the Ministry manages 16 information resources, which ensure data availability to the population, efficient activity of the services, and operation ... ... Process maturity examination can help in IT audit ... also flaws in change management and security processes. But the finding, which gave them the key to the root cause of problems, was connected with maturity assessment of the auditee's IT processes. ... Main risk areas in case of this audit were strategic and organisational - Ministry’s weak ownership of IT resources, insufficient audit and internal control function. SAI Lithuania auditors found
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National Audit Office of the Republic of Lithuania
, issued in 2016
Risk cases: 4
Opportunities Exist for SEC to Improve Its Controls over Financial Systems and Data
. In carrying out its mission, the SEC relies on computerized information systems to collect, process, and store sensitive information, including financial data. Having effective information security controls ... The SEC is responsible for enforcing securities laws, issuing rules and regulations that provide protection for investors, and helping to ensure that the securities markets are fair and honest ... in place is essential to protecting these systems and the information they contain. <br/> This report details weaknesses GAO identified in the information security program at SEC during its audit ... IT security basics under scrutiny ... Financial audit by US GAO was accompanied by an IT examination focused on information security measures in the Securities and Exchange Commission (SEC). GAO found that SEC’s systems could ... be compromised, because of risks jeopardizing the confidentiality, integrity, and availability of sensitive financial information.
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. In carrying out its mission, the SEC relies on computerized information systems to collect, process, and store sensitive information, including financial data. Having effective information security controls ... The SEC is responsible for enforcing securities laws, issuing rules and regulations that provide protection for investors, and helping to ensure that the securities markets are fair and honest ... in place is essential to protecting these systems and the information they contain. <br/> This report details weaknesses GAO identified in the information security program at SEC during its audit ... IT security basics under scrutiny ... Financial audit by US GAO was accompanied by an IT examination focused on information security measures in the Securities and Exchange Commission (SEC). GAO found that SEC’s systems could ... be compromised, because of risks jeopardizing the confidentiality, integrity, and availability of sensitive financial information.
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General Accountability Office
, issued in 2016
Risk cases: 5
Homeland Security. Oversight of Neglected Human Resources Information Technology Investment Is Needed
Human resources IT investments get stuck in management's lack of interest Although the Human Resources Information Technology (HRIT) investment was initiated about 12 years ago with the intent to consolidate, integrate, and modernize the department's human resources IT infrastructure, the Department of Homeland Security (DHS) has made very limited progress in achieving these goals. HRIT's minimally involved executive steering committee during a time when significant problems were occurring was a key factor in the lack of progress. This is particularly problematic given that the department's ability to efficiently and effectively carry out its mission is significantly hampered by its fragmented human resources. DHS's ineffective management of HRIT, such as the lack of an updated schedule and a life-cycle cost estimate, also contributed to the neglect this investment has experienced. DHS will be limited in efficiently tracking and reporting accurate, comprehensive performance and learning management data across the organization, and could risk further implementation delays.
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Human resources IT investments get stuck in management's lack of interest Although the Human Resources Information Technology (HRIT) investment was initiated about 12 years ago with the intent to consolidate, integrate, and modernize the department's human resources IT infrastructure, the Department of Homeland Security (DHS) has made very limited progress in achieving these goals. HRIT's minimally involved executive steering committee during a time when significant problems were occurring was a key factor in the lack of progress. This is particularly problematic given that the department's ability to efficiently and effectively carry out its mission is significantly hampered by its fragmented human resources. DHS's ineffective management of HRIT, such as the lack of an updated schedule and a life-cycle cost estimate, also contributed to the neglect this investment has experienced. DHS will be limited in efficiently tracking and reporting accurate, comprehensive performance and learning management data across the organization, and could risk further implementation delays.
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US Government Accountability Office
, issued in 2016
Risk cases: 1
Federal Human Resources Data
Internal control weaknesses may put mission at risk GAO audited the Enterprise Human Resources Integration payroll data warehose. The American auditors pointed at problems that may impede 'leverage of these data to meet its mission and allow others to make full use' of them. The critical internal contols areas to be improved in this cas are: completeness, accuracy, and validity of information, authorization, documentation, monitoring, results' evaluation.
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Internal control weaknesses may put mission at risk GAO audited the Enterprise Human Resources Integration payroll data warehose. The American auditors pointed at problems that may impede 'leverage of these data to meet its mission and allow others to make full use' of them. The critical internal contols areas to be improved in this cas are: completeness, accuracy, and validity of information, authorization, documentation, monitoring, results' evaluation.
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General Accountability Office
, issued in 2016
Risk cases: 2
Performance measurement by regulators
Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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Performance measurement for regulators Primary adressees of this good practice guide - by the British NAO - are regulators, the public institutions established for making sure that an industry or system works legally and fairly. But we are sure that many more can find this guidance useful - including auditors. NAO presents a comprehensible framework for performance measurement and hints how to focus on influence that regulators can use.
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National Audit Office
, issued in 2016
Risk cases: 2
Use of consultants and temporary staff
New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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New skills needed in a longer term UK NAO: Used well, consultants and temporary staff can be an important source of specialist skills and capabilities that are uneconomic for departments to maintain in their permanent staff. Since 2009-10, the government has used spending controls to reduce its use of consultants and temporary staff, and by 2014-15 spending had fallen by £1.5 billion. However, spending has increased by between £400 million and £600 million since 2011-12, suggesting that this was more of a short-term reduction than a sustainable strategy. In the longer term, departments will need to develop workforce, skills and capacity plans to reduce their dependence on external skills. They will need to improve their strategic workforce planning to determine where they can deploy existing staff, where they need to recruit, and where they need to engage temporary resources. Without this, departments cannot demonstrate that they are achieving value for money from the use of consultants and temporary staff.
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National Audit Office
, issued in 2016
Risk cases: 7
FEMA Needs to Address Management Weaknesses to Improve Its Systems
Controls in emergency management GAO audited the agency of the Department of Homeland Security, responsible for federal efforts to mitigate, respond to, and recover from disasters. American auditors recommend that the agency fully define its investment board’s roles and responsibilities and procedures for selecting and overseeing investments, update its strategic plan and complete plans for IT modernization, and establish time frames for completing workforce planning efforts. The agency should also establish policies and guidance for implementing key IT management controls.
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Controls in emergency management GAO audited the agency of the Department of Homeland Security, responsible for federal efforts to mitigate, respond to, and recover from disasters. American auditors recommend that the agency fully define its investment board’s roles and responsibilities and procedures for selecting and overseeing investments, update its strategic plan and complete plans for IT modernization, and establish time frames for completing workforce planning efforts. The agency should also establish policies and guidance for implementing key IT management controls.
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General Accountability Office
, issued in 2016
Risk cases: 4