Inspector OIG Case

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Conclusion:
The Office of Inspector General (OIG) determined the Chief of Psychology Service maintains direct oversight of the accused and permitted overtime use to address access issues at the Temple, VAMC. Further, OIG established that the accused operated outside of a scheduling grid and the Chief of Psychology was unable to provide effective oversight related to scheduling, proper training, and effective use of overtime. Additionally, OIG concluded evidence of improper coding transpired and Chief of Psychology, after being present the facts, concurred but he linked that assessment to lack awareness by the accused.
Discussion:

Introduction occurred with Dr. Fred Willoughby and members of the 52 KC audit team onsite. Office of Inspector …show more content…
Willoughby to describe the overtime (OT) process and rationale for approval with Military Sexual Trauma (MST). The Chief of Psychology cited access to care as the main reason for overtime and cited a report indicating this program had the third highest in the country related to access issues. He reportedly asked for volunteers ahead of time, earmarked for direct patient care, and discussed it in one of their Tuesday meetings.
OIG asked how he ensured direct patient care for the overtime. He reportedly created a clinic and in some cases, double book appointments and the provider could see scheduling. OIG asked how he determine if OT was effectively used. Dr. Willoughby cited encounters closed and access but didn’t look at it that at the time. After looking at the numbers, Dr. Willoughby stated that better utilization could have been done.
OIG cited several examples where Dr. Alexander worked overtime where she had given herself 9 RVUs for one encounter, some related to ADHD, background, and interpretation. Dr. Willoughby agreed it was over coding. In the example presented, Dr. Alexander had 5 no shows on one day with one encounter seen and 4 no shows the next weekend and one encounter seen. OIG inquired about the appropriate used of time. Dr. Willoughby noted he would need to examine but one was adjusted to 7

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