Budget Request – Fiscal Year 2024

The U.S. Office of Personnel Management (OPM) Office of the Inspector General (OIG) is requesting $45,784,000 for its fiscal year (FY) 2024 budget. This request is composed of $7,066,000 from the Salaries and Expenses (S&E) General Fund and $38,718,000 from the OPM Trust Funds.

Salaries & Expenses and Trust Fund

The OPM OIG is requesting an increase of $9,389,000: $158,000 in S&E General Fund and $9,231,000 in OPM OIG Trust Funds appropriations.

Budgetary Resources	FY 2022 Enacted Dollar	FY 2022 Enacted FTE	FY 2023 Enacted Dollar	FY 2023 Enacted FTE	FY 2024 Enacted Dollar	FY 2024 Enacted FTE
Salaries & Expenses	$5,150,000	21	$6,908,000	22	$7.066,000	26
Trust Fund Annual	$28,083,000	136	$29,487,000	143	$38,718,000	186
Total Discretionary (dollars)	$33,233,000	157	$36,395,000	165	$45,784,000	212

Revolving Fund

For FY 2024, the OPM OIG estimates that $1,600,000 and seven full-time equivalent positions will be required for OPM Revolving Fund (RF) oversight activities. Currently, the OPM RF consists of the following programs: Human Resources Solutions (HRS), Enterprise Human Resources Integration, Human Capital Data Management and Modernization, HRS Information Technology Program Management Office, Suitability Executive Agent, Credit Monitoring, and Federal Executive Boards.

Budgetary Resources	FY 2022 Enacted Dollar	FY 2022 Enacted FTE	FY 2023 Enacted Dollar	FY 2023 Enacted FTE	FY 2024 Enacted Dollar	FY 2024 Enacted FTE
Revolving Fund (Estimated)	$1,500,000	7	$1,545,000	7	$1,600,000	7
OIG Total (dollars)	$1,500,000	7	$1,545,000	7	$1,600,000	7

Additional Investments

The OPM OIG requests additional investments in the following areas:

Discretionary	FY 2022 Enacted	FY 2023 Enacted	FY 2024 Request	Difference
Base	$33,233,000	$36,395,000	$36,395,000	-
Adjustments to Base - Salary 5.2% increase	-	-	$850,000	$850,000
Adjustments to Base - Benefits 4.1% increase	-	-	$281,000	$281,000
2024 Pay Raise-Benefits Increase/Decrease	-	-	$1,131,000	$1,131,000

Program Changes (Increases/Decreases)	Increases	Difference
Personnel Needed to Leverage and Secure Advanced Data Capabilities	$1,889,000	$1,889,000
Inspector General Independence	$1,269,000	$1,269,000
Office of Evaluations Investment	$156,000	$156,000
Administrative Sanctions Program Investment	$117,000	$117,000
Ensuring Diversity, Equity, Inclusion, and Accessibility	$581,000	$581,000
Additional OPM OIG Investment	$288,000	$288,000
Postal Service Health Benefit Oversight	$2,612,000	$2,612,000
Maturing the Advanced Analytics Program	$867,000	$867,000
Additional Investment in Legal Staff	$479,000	$479,000
FY 2024 Program Increases/Decreases	$8,258,000	$8,258,000

Discretionary	FY 2022 Enacted	FY 2023 Enacted	FY 2024 Request	Difference
Base	$33,233,000	$36,395,000	$36,395,000	-
Total Appropriated	$33,233,000	$36,395,000	$45,784,000	$9,389,000
Total FTE	157	165	212	47

Budget Investments – FY 2024

Fully Funding Initiatives Requested in FY 2022 and 2023 ($4,300,000 for 29 FTE)

The OPM OIG’s recent Congressional Budget Justifications (CBJs) detailed the organization’s vision for maturing its advanced data analytics program and establishing the OPM OIG as an entity that is operationally independent from its parent agency. These initiatives continue to be the primary priority of the organization, as both are foundational elements of the recently developed OPM OIG FY 2023–2028 Strategic Plan.

Advanced Data Analytics Program

In its FY 2022 budget request, the OPM OIG outlined its vision for implementing an advanced data analytics program to help detect fraud, waste, and abuse in the Federal Employees Health Benefits Program (FEHBP). With its modernized data engineering platform in place, the organization is positioned to move from a reactive oversight model to a proactive one where data drives the oversight work.

The OPM OIG collects, stores, and analyzes billions of highly sensitive medical claim records from individuals participating in the FEHBP. The data originates from the various individual private health insurance carriers that participate in the FEHBP (e.g., BlueCross BlueShield, Aetna). The OPM OIG’s information systems provide an integrated view of the FEHBP population, and no other entity possesses a consolidated claims data repository like that owned and operated by the OPM OIG. The OPM OIG has developed a unique data engineering program with complex data extraction and manipulation processes catered towards staging the FEHBP claims data for downstream data science methods such as artificial intelligence and machine learning. For these reasons, it is imperative that the OPM OIG establish a mature data analytics program separate and distinct from any other shared service analytics programs in Government.

Although the OPM OIG was able to partially fund this initiative with its increased FY 2023 appropriations, it cannot fully migrate to a proactive oversight model (one where data generates audit/investigation leads) until this program is fully funded with both the information technology and personnel needed to support it.

Inspector General Independence

The OPM OIG’s FY 2023 CBJ outlined the imperative need to establish the Inspector General as operationally independent from the Director of OPM. The Inspector General Act of 1978, as amended, commonly known as the IG Act, identifies Inspector General (IG) independence as necessary for effective oversight. In fact, Congress has continuously prioritized introducing and passing legislation that enhances the protections for IG independence. Independence is essential to not only the credibility of an OIG but also to ensuring the OIG is able to efficiently and effectively audit, evaluate, review, and investigate agency fraud, waste, abuse, and mismanagement.

Although the OPM OIG operates independently from OPM in many areas (e.g., information technology and procurement), it is still heavily dependent on the parent agency for Human Resources (HR) and Legal Services. As a result of this dependency, the OPM OIG is bound by OPM’s policies, procedures, and time frames and is not able to make fully independent personnel decisions and actions. When HR-related legal needs arise, the OPM’s Office of General Counsel represents the IG, which is in conflict with the IG Act’s requirement that an IG “obtain legal advice from a counsel either reporting directly to the Inspector General or another Inspector General.” Although the OPM OIG has a strong working relationship with OPM, it is only one of OPM’s many consumers of HR and Legal Services.

The current arrangement represents a conflict of interest and weakens the OPM OIG’s independence. As the oversight body for the agency, the OPM OIG could potentially be responsible for investigating individuals that represent the office in HR and litigation actions. OPM is also in a position to impact the timeframe it takes to recruit and onboard critical oversight personnel for the OIG.

Other Unfunded Initiatives

In addition to the two primary objectives described above, the OPM OIG has not been able to fully fund initiatives related to:

• Enhancing its Administrative Sanctions Program;
• Strengthening its Office of Evaluations;
• Developing additional audit support software systems;
• Establishing a paid internship program in support of Diversity, Equity, Inclusion, and Accessibility;

Each of these remain a strategic goal of the organization, and the OPM OIG is dedicated to fully implementing them if funded.

Oversight of U.S. Office of Personnel Management’s Implementation of the Postal Service Reform Act of 2022 ($2,612,000 for 13 FTE)

On April 6, 2022, President Biden signed into law the landmark Postal Service Reform Act of 2022 (Act) (Public Law No. 117–108). The law establishes a new Postal Service Health Benefits Program (PSHBP) within the FEHBP. Congress appropriated $70,500,000 (for FY 2022 until expended) to OPM to implement the requirements of the law. It is essential that the OPM OIG be resourced commensurate with OPM to ensure the oversight of the development, implementation, and administration of the PSHBP is conducted in a secure, effective and efficient manner by OPM.

The OPM OIG’s Office of Audits and the Office of Evaluations will need to conduct continuous oversight and periodic audits/evaluations during the development, implementation, and administration of the PSHBP. This will require staff experienced in project management oversight, conducting issue-based studies of OPM programs focused on program effectiveness, and knowledge of OPM’s Healthcare & Insurance Program. The OPM OIG meets regularly with OPM’s Healthcare & Insurance’s PSHBP implementation team to provide proactive oversight rather than waiting until OPM’s implementation is completed. This proactive approach will strengthen OPM’s controls and improve the chances of a successful development and implementation.

Early OIG involvement and oversight of major program management activities are key to ensuring successful outcomes that deliver services to enrollees and the public and safeguard taxpayer dollars. The OPM OIG has firsthand experience with previous challenges OPM has encountered when the OIG was not utilized for collaboration and proactive oversight. For example, OPM’s information technology (IT) modernization project known as ‘Shell’ was initiated in 2016 without OPM OIG involvement. The project was ultimately a major failure for the agency and cost taxpayers tens of millions of dollars.

The OPM OIG’s Office of Investigations will focus on oversight of the PSHBP’s procurement process while the program is established within OPM; liaison with the agency/PSHBP on matters related to fraud, waste, and abuse within the program; and conduct investigations related to the disbursement of program benefits, including health care fraud during the administration phase.

The OIG cannot delay until the PSHBP is established to begin oversight. Current investigative resources are already operating at maximum capacity investigating fraud, waste, and abuse in existing OPM programs. Adding investigative resources simultaneously with OPM’s implementation of administrative, hiring, and procurement processes is crucial because past experience demonstrated that those activities are vulnerable to fraud, waste, and abuse. The OPM OIG is particularly concerned about potential procurement fraud, hiring officials engaging in prohibited personnel practices, or other financial violations such as health care fraud that can occur once the PSHBP begins disbursing benefits. Fraud in enrollment eligibility is also an area of concern for the OPM OIG. The Office of Investigations has recently investigated these enrollment issues in OPM programs and is concerned similar issues could potentially affect the PSHBP.

Effective coordination with the new OPM PSHBP office will improve the Office of Investigations’ abilities to determine potential vulnerabilities (including areas of long-term, programmatic concern) and train and support the oversight activities of Office of Investigations staff and Federal law enforcement partners such as the U.S. Department of Justice and U.S. Attorneys’ Offices nationwide for successful judicial prosecutions and financial recoveries of improper payments.

Maturing the Advanced Analytics Program ($667,000 for 3 FTE and $200,000)

Information Technology Program Management Office

Over the last several years the OPM OIG has significantly expanded its IT portfolio to include multiple cloud-based information systems that include software applications supported by multiple vendors. It is imperative that the OPM OIG establish a centralized IT Program Management Office (PMO) to ensure that all IT investments remain aligned with both the OPM OIG’s mission, its enterprise architecture, and its updated Strategic Plan.

The establishment of a centralized PMO will allow the OPM OIG to allocate full-time resources to the critical role of IT portfolio management. The PMO will be a bridge between the business units and the contracting team, ensuring alignment between the organization’s IT acquisitions and its strategic goals.

The PMO will also manage projects from an enterprise level rather than focusing only on a single business unit, thereby increasing efficiency in IT operations. This will lead to consolidation of information systems on enterprise-wide platforms, ultimately leading to direct cost savings and critical cybersecurity and IT management benefits.

Data Analytics Center of Excellence

With the recent modernization of its technical environment, the OPM OIG is poised to establish a data analytics Center of Excellence (CoE) to further leverage its IT capabilities. The CoE will be a formal body of knowledge on data analytics with the goal of providing expertise, managing governance practices, and supporting projects associated with data analytics.

In the long term, the CoE will be tasked with:

• Developing and implementing policies and best practices on data governance, data engineering, and data analytics with a focus on value generation;
• Providing training to broaden data literacy and the analytics capabilities of business and power users;
• Building data science capability through hiring data scientists and data engineers as a part of the CoE that will work with business units to develop analytics services to enable data-driven decision-making; and
• Maintaining self-service cloud-based data analytic platforms such as data warehouses, data discovery, self-service visualization, and machine learning analytics tools.

Data Scientist: The OPM OIG intends to hire a highly skilled Data Scientist to support our office’s advanced data analytics program. The candidate recruited for this position will have extensive experience and advanced degrees in the fields of engineering, health care, and/or statistics.

The OPM OIG has been very successful in analyzing and mining its FEHBP health care data for audit and investigative purposes, and this system is the source of millions of dollars in financial recoveries and multiple criminal convictions every year. Investments in data analytics would allow for greater maximization of this data for identifying fraud. The evolving nature of health care fraud tactics necessitates advancements in data analytics to stay on top of existing known trends, much less detect newly emerging trends or predict future fraud schemes. The Data Scientist will not only improve the efficiency of health care data mining and querying but can implement modern concepts such as machine learning and predictive analytics.

Training Program for the OPM OIG’s Data Analytics Program: Another pillar of the OPM OIG CoE is a formal data analytics training program. The CoE will provide coaching and support to the entire OPM OIG for adopting an enterprise-wide data-centric culture. The OPM OIG’s mission of combating fraud, waste, and abuse in the FEHBP requires knowledge in the fields of technology, analytics, and health care. While commercial training courses may offer instruction in one of these fields, the OPM OIG needs a customized training program tailored to its unique mission. The OPM OIG’s broad user community needs to be proficient in using the specific technology toolset that was developed to analyze this unique health care data set.

The CoE training program will be built around the OPM OIG’s business model and will provide specific and relevant analytics training to auditors, investigators, and evaluators. The training program will include live classroom training, on-demand video training, and knowledge base repositories (i.e., wiki pages). The training will include both the routine use of analytics tools for business users and advanced data visualization as well as analytical methods regarding artificial intelligence and machine learning algorithms for power users. The training program will ultimately empower the business users to adopt data analytics tools and improve our ability to more proactively identify fraud, waste, and abuse in OPM programs.

Additional Investment in Legal Staff ($479,000 for 2 FTE)

Whistleblower Protection Coordinator

With the addition of a dedicated FTE focused on the Whistleblower Protection Coordinator (WPC) duties and responsibilities, the OPM OIG can continue to build out the Whistleblower Protection Program, allowing the OPM OIG to increase whistleblower protection education agency-wide and increase its engagement with potential whistleblowers. A dedicated WPC will also allow the OPM OIG to develop the Program while not sacrificing the investigative work associated with retaliation cases or the other legal work currently performed by the OPM OIG Office of Legal and Legislative Affairs (OLLA). It is well established that a WPC who can educate agency staff is in the best interest of not only the OPM OIG but also the Federal Government as a whole, and the OPM OIG is committed to making these functions a priority.

Debarring Official

The OPM OIG Debarring Official plays a critical role in the sanctions and debarment process, acting in the best interest of FEHBP enrollees and the Federal Government by considering on a case-by-case basis proposed suspensions, debarments, and contests. The Assistant Inspector General for Legal & Legislative Affairs is currently serving as the OPM OIG Debarring Official. The OPM OIG’s Debarring Official is responsible for its Administrative Sanctions function as well as interacting with the Interagency Suspension and Debarment Committee (ISDC), which is comprised of debarring officials from agencies governmentwide.

As of September 30, 2022, over 38,000 health care providers were currently suspended or debarred from participating in the FEHBP. In FY 2022, the OPM OIG debarred or suspended 850 health care providers from participating in the FEHBP.

Many of the OPM OIG’s debarment actions are based on the U.S. Department of Health and Human Services’ (HHS) exclusion of the health care providers from Medicare and Medicaid. The OPM OIG has increased its efforts to identify health care providers who under the statute should not participate in the FEHBP and taken independent action to suspend or debar health care providers. With a very small staff, the OPM OIG has increased the number of suspensions and debarments initiated by our office over the past 3 fiscal years, from 63 in FY 2019 to 91 in FY 2020 and 132 in FY 2021 – a 45-percent increase over the past fiscal year and over a 100-percent increase over the past 3 fiscal years. These self-initiated cases require more staff time and more attention from the Debarring Official.

A dedicated FTE focused on the Debarring Official responsibilities is also necessary as the OPM OIG fully expects for HHS exclusions to increase to pre-pandemic levels. This combined with the increased OPM OIG self-initiated cases and the other sources of debarments presents a workload level that will require the focus of an FTE without additional responsibilities.

Personnel Cost Increases ($1,131,000)

Pay Raise ($850,000)

The Biden Administration proposes a 5.2-percent pay raise for FY 2024. The proposed 5.2-percent pay raise will result in additional personnel costs totaling $850,000 for the OPM OIG.

Benefit Increase ($281,000)

For FY 2024, the OPM OIG health benefits assumption is an average increase of 4.1-percent. This increase will result in additional personnel costs totaling $281,000 for the OPM OIG.

Back to Top

OPM OIG Overview

The OPM OIG was established as a statutory entity on April 16, 1989. It operates under the authority of the Inspector General Act of 1978 (Public Law (P.L.) 95–452), as amended.

The OPM OIG offices provide comprehensive and cohesive oversight of OPM programs. Ongoing key initiatives include identifying and recommending recovery of improper payments related to the FEHBP and retirement annuities, ensuring OPM and its contractors implement critical cybersecurity controls, and using proactive data analytics methods to combat the effects of the COVID-19 pandemic and opioid epidemic on the FEHBP and its enrollees.

The OPM OIG is comprised of the following organizational components:

The Office of Audits

The Office of Audits conducts comprehensive, independent, and risk-based audits of OPM programs, operations, and contractors. The office’s core responsibility is auditing OPM contractors that underwrite and provide health and life insurance benefits to Federal employees, annuitants, and their eligible dependents and survivors through the FEHBP and the Federal Employees’ Group Life Insurance program. Audits issued by the office annually lead to the recovery of tens of millions of dollars of improper payments from the OPM trust funds.

The Office of Investigations

The Office of Investigations conducts criminal, civil, and administrative investigations of fraud, waste, and abuse related to OPM programs and operations and investigates OPM employee and contractor misconduct or violations of criminal law. The office actively coordinates with the U.S. Department of Justice and other Federal, State, and local law enforcement authorities on investigations that lead to criminal prosecutions, criminal and civil monetary recoveries, administrative corrective actions, and exclusions from participation in Federal health care programs and contracts.

The Office of Evaluations

The Office of Evaluations conducts broad, issue-based studies of OPM programs that focus on program effectiveness and rely on in-depth analysis using multiple sources of data. The office combines the scoping and planning of traditional audits with a more reactive nature similar to investigations to quickly respond to high priority issues requiring immediate attention.

The Office of Management

The OPM OIG’s Office of Management is responsible for managing OPM OIG functions related to IT, data management, human capital, budget, procurement, and facilities. The OPM OIG independently maintains its own internal IT infrastructure within the broader OPM technical environment, and the office is currently building out an advanced data analytics program to support its oversight work.

The Office of Legal and Legislative Affairs

The Office of Legal and Legislative Affairs provides legal advice and representation to the IG and OPM OIG employees nationwide. The office also renders opinions on OPM programs and operations; provides legal support for the OPM OIG’s internal operations, including personnel and administration; and serves as the liaison to Congress and the media. The Debarring Official also resides within OLLA and is responsible for suspending and debarring from participation in the FEHBP health care providers who have committed various criminal and professional violations.

OPM OIG Performance Metrics and Other Statistical Information

Performance Metrics

The following performance metrics demonstrate how the OPM OIG measures improvements in organizational effectiveness in the accomplishment of its mission and goals.

Performance Metric	FY 2021 Result	FY 2022 Result	FY 2023 Goal	FY 2024 Goal
Percentage of Items Completed on Audit Agenda, in accordance with Yellow Book Standards	97%	100%	90%	90%
Percentage of Audit Reports issued that meet OIG timeliness and quality guidelines	96%	90%	90%	90%
Percentage of investigative cases closed during a fiscal year which resulted in successful outcome (i.e., criminal action, civil action, or administrative action)	98%	97%	90%	90%
Percentage of quality improvement recommendations (revisions to contracts, policies, carrier letter, etc.) accepted by OIG senior staff and referred to stakeholders to mitigate fraud, waste, and abuse	90%	93%	90%	90%
Percentage of Suspension and Debarment referrals that are issued within OIG timeliness and regulatory standards (new measure)	N/A	N/A	85%	85%

Other Statistical Information

The following statistical information demonstrates to the public the impact of the collective efforts of the OPM OIG, OPM, and its contractors in reducing fraud, waste, and abuse. The statistical information reported by the OPM OIG, while indicative of the effectiveness of its oversight, is not solely under the control of or based on the OPM OIG’s efforts.

Statistical Information	FY 2020 Result	FY 2021 Result	FY 2022 Result
Positive Financial Impact Using Questioned Costs	$81,301,015	$72,561,951	$69,522,235
ROI Using Questioned Costs	$2.80	$2.40	$2.28
Positive Financial Impact Using Management Commitment to Recover Funds	$59,257,326	$48,756,232	$52,404,850
ROI Using Management Commitment to Recover Funds	$2.00	$1.60	$1.72
Questioned Costs	$23,522,728	$29,958,345	$10,445,548

FEHBP Audit Cycles (in years)A	Target	FY 2020 Result	FY 2021 Result	FY 2022 Result
Experience Rate Carrier Audits	7	9.8	15	15
Community Rated Carrier Audits	5	21.4	17.2	15.1
Carrier IT Security Audits	6	9.3	8.2	7.6
Audit Recovery RateB	-	39%	43%	50%

Statistical Information	FY 2020 Result	FY 2021 Result	FY 2022 Result
Number of Debarments and Suspensions	776	710	850
Number of Debarment and Suspension Inquiries	4,479	3,609	3,298

FY 2024 Budget Request by Object Class

Salaries and Expenses by Object Class

Object Class	FY 2023 Enacted	FY 2024 Request	Increase/Decrease
Personnel compensation	$3,251,000	$3,378,000	$127,000
Personnel benefits	$1,015,000	$1,046,000	$31,000
Travel and transportation of persons	$22,000	$22,000	$0
Transportation of things	$0	$0	$0
Communications, utilities, and rent	$1,773,000	$1,774,000	$1,000
Printing and reproduction	$0	$0	$0
Other services	$847,000	$846,000	($1,000)
Supplies and materials	$0	$0	$0
Equipment	$0	$0	$0
Land and structures	$0	$0	$0
Total Object Class	$6,908,000	$7,066,000	$158,000
FTE	22.0	26.0	4.0

Trust Fund Limitations – Budget by Object Class

Object Class	FY 2023 Enacted	FY 2024 Request	Increase/Decrease
Personnel compensation	$17,226,000	$23,246,000	$6,020,000
Personnel benefits	$5,777,000	$8,500,000	$2,723,000
Travel and transportation of persons	$515,000	$515,000	$0
Transportation of things	$10,000	$10,000	$0
Communications, utilities, and rent	$2,543,000	$2,543,000	$0
Printing and reproduction	$20,000	$20,000	$0
Other services	$2,823,000	$3,311,000	$488,000
Supplies and materials	$76,000	$76,000	$0
Equipment	$497,000	$497,000	$0
Land and structures	$0	$0	$0
Total (dollars)	$29,487,000	$38,718,000	$9,231,000
FTE	143.0	186.0	43.0

Additional Reporting Requirements

The following information is provided to adhere to the requirements of the Inspector General Reform Act of 2008 (P.L. 110–498):

Participation in CIGIE Resource Summary – includes all resources (dollars)

Budget Source	FY 2023 Enacted Dollars	FY 2023 Enacted FTE	FY 2024 Request Dollars	FY 2024 Request FTE	Increase/ Decrease Dollars	Increase/ Decrease FTE
OIG Salaried and Expenses	$24,869	0.0	$28,264	0.0	$3,395	0.0
OIG Trust Funds	$106,153	0.0	$154,872	0.0	$48,719	0.0
OIG Total (dollars)	$131,022	0.0	$183,136	0.0	$52,114	0.0

Training Resource Summary – includes all resources (dollars)

Budget Source	FY 2023 Enacted Dollars	FY 2023 Enacted FTE	FY 2024 Request Dollars	FY 2024 Request FTE	Increase/ Decrease Dollars	Increase/ Decrease FTE
OIG Salaried and Expenses	$14,973	0.0	$14,973	0.0	$0	0.0
OIG Trust Funds	$218,048	0.0	$561,048	0.0	$343,000	0.0
Revolving Fund (Estimated)	$6,276	0.0	$6,276	0.0	$0	0.0
OIG Total (dollars)	$239,297	0.0	$582,297	0.0	$343,000	0.0

Back to Top