Bobby Scott Asks Witness If Federal Workers’ Compensation Is More Prone To Fraud Than Other Insurances

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During a House Education and the Workforce Committee hearing prior to the Congressional recess, Rep. Bobby Scott (D-VA) questioned Luiz Santos, Acting Inspector General of the U.S. Department of Labor, about fraud within the Federal Employees' Compensation Program.

Transcript

00:00Thank you. Next, we'll go to Ranking Member Scott.

00:08Thank you. Thank you, Mr. Chairman. Mr. Santos, you mentioned the scheme involving

00:28compound drugs, where I think you mentioned they mix up about $15 worth of materials and

00:34then charge $16,000. Did you refer any of the doctors or physicians to the licensing boards

00:43as that investigation was going on? Thank you, Ranking Member Scott. I know this

00:49is a matter that is close to your heart. We've discussed this with your office for many years

00:55now. These cases go back to really the beginning of the issues involving compounded creams,

01:01which were originally identified by both our office and postal OIG office. And in the course

01:07of our investigations, we have referred many medical providers to include doctors to their

01:12respective boards for suspension as well. Has the actions of DOGE reduced your capacity

01:23to do your job, canceling leases, credit cards, or anything? Thank you, Ranking Member. There

01:29has been some limited impact on the ability of labor OIG to conduct its work. I believe four

01:36of our leases were included in the government-wide cancellation of commercial leases. Since then,

01:41I've engaged with both the Secretary and the Deputy Secretary at DOE manages our space program.

01:47They have been very supportive of the need for labor OIG to continue maintaining these geographic

01:53locations, geographical locations. Many of these offices were law enforcement offices, so we have

01:58very specific space requirements such as weapons storage, grand jury information, evidence rooms,

02:04interview rooms. And my understanding at this point in time is that some of these decisions are

02:09being revisited, and I'm certainly hopeful that we'll be able to maintain these locations. The same is true

02:16for the purchase cards and the travel cards. OIG was, in fact, impacted originally by having the

02:25suspension of both purchase cards and travel cards. I engaged with DOE leadership immediately,

02:31and within hours they understood the requirement for law enforcement to continue its work and reverse

02:36those decisions. So, again, it has had some limited impact on our work. Thank you.

02:41Thank you. Can you say whether or not FECA is more vulnerable to fraud than other health insurances?

02:47I cannot say that, Ranking Member Scott. I believe that the issues we find in the FECA program as it

02:55relates to both claimant fraud and medical provider fraud are very similar to the issues that are identified by

03:02by other law enforcement programs in programs such as Tricare or Medicare or Medicaid or in the private sector.

03:12So the same types of schemes and in targeting of the system, we see that in the FECA program as well.

03:19So now I think it's very much a similar situation than many other health care benefit programs.

03:26Thank you. Mr. Renfro, we've heard about the problems with heat and crime. There's legislation

03:33that's been pending about heat stress where at certain temperatures and whatnot you have to take

03:40certain actions. Are you prevented? You've been trained, apparently, to recognize problems. Workers have

03:47been trained. Is there any limitation or resistance to them taking a break when the heat gets to a certain

03:56temperature, humidity at a certain temperature, when heat stroke is much more possible?

04:06So the Postal Service has a heat illness prevention plan, a HIP as it's called, in place. It has been in

04:15place for a few years. In fact, the earlier discussions that OIG Hull was referencing about

04:22training, the issue we had with training a couple of years ago, is part of that HIP. The problem with

04:30that HIP is it does not include all of the necessary mitigating factors that experts recommend to avoid

04:39the hazard of excessive heat, such as a regimented work rest, a work rest regimen. When an employee is not in

04:50the heat for a period of time due to vacation or illness or they're off work, in a climatization

04:55period when they return, those are currently missing from the plan. There is a pending rule that would

05:05apply a heat safety standard to workers all across the country. We have, of course, been in communication

05:10with the Department of Labor about that. We strongly support that rule.

05:15Thank you. And Mr. Seema-Delra, do you know how long it takes to get a disability claim

05:24appealed if you have a problem, if you disagree with the analysis?

05:28I don't have that data available.

05:34Does anybody on the panel know how long it takes to take a disability appeal?

05:39Thank you. Thank you. Thank you, Mr. Chairman.

05:45Thank you. Next one.

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