Office of the Inspector General
The U.S. Office of Personnel Management (OPM) Office of the Inspector General (OIG) fiscal year (FY) 2025 Budget request totals $42,700,000. This amount is comprised of $7,144,000 from the Salaries and Expenses (S&E) General Fund and $35,556,000 from the OPM Trust Funds.
The OPM OIG greatly appreciates the support that Congress has shown the OPM OIG through the annual appropriations process. The OPM OIG respectfully requests that Congress continue to make the OPM OIG a funding priority in FY 2025.
Budget Request – Fiscal Year 2025
Budgetary Resources | Salaries & Expenses $ |
Salaries & Expenses FTE |
Trust Fund $ |
Trust Fund FTE |
Total $ |
Total FTE |
---|---|---|---|---|---|---|
FY 2024 Annualized CR Base | $6,908,000 | 22.0 | $29,497,000 | 143.0 | $36,395,000 | 165.0 |
FY 2025 CBJ Adjustments to Base | $236,000 | 0.0 | $2,438,000 | 0.0 | $2,674,000 | 0.0 |
FY 2025 CBJ Program Increases | $0 | 0.0 | $3,631,000 | 18.0 | $3,631,000 | 18.0 |
FY 2025 CBJ Total Increases | $236,000 | 0.0 | $6,069,000 | 18.0 | $6,305,000 | 18.0 |
FY 2025 CBJ Total Request | $7,144,000 | 22.0 | $35,566,000 | 161.0 | $42,700,000 | 183.0 |
The OPM OIG’s FY 2025 discretionary budget request represents a $6,305,000 (17.3 percent) increase over FY 2023 enacted levels. This amount is comprised of the following:
Adjustment to Base
Over 40 percent of the requested increase is needed to maintain current oversight work, including meeting government-wide obligations to fund previously-enacted federal employee pay increases and required adjustments to employee health benefit contributions. This includes a 5.2 percent 2024 federal pay raise and 2.0 percent 2025 federal pay raise consistent with the President’s pay proposal.
Program Increase - Oversight of the Postal Service Health Benefits Program
The OPM OIG continues to have a critical need to fund oversight of the OIG’s implementation of the Postal Service Reform Act of 2022 (Public Law No. 117–108). The law establishes a new Postal Service Health Benefits Program (PSHBP) within OPM’s Federal Employees Health Benefits Program (FEHBP). Congress appropriated $70,500,000 (for 2022 until expended) to OPM to implement the requirements of the law. It is essential that the OPM OIG’s oversight work be resourced commensurate with OPM to ensure that the development, implementation, and administration of the PSHBP is conducted in a secure, effective, and efficient manner by OPM. The PSHBP risks annual losses of millions of taxpayer dollars due to fraud, waste, or abuse as the program begins enrollment and disbursing benefits. It faces similar risks as the FEHBP of health care fraud schemes and improper payments. The FEHBP already pays tens of millions of dollars annually in improper payments.
Program Increase - OPM OIG Data Analytics Program
In its 2022 budget request, the OPM OIG outlined a comprehensive vision for implementing an advanced data analytics program to help proactively detect fraud, waste, and abuse in the FEHBP. Although the OPM OIG was able to partially fund this initiative with its increased 2023 appropriations, it cannot fully migrate to a proactive oversight model (one where data generates audit/investigation leads on suspected fraud and improper payments) until this program is fully funded with the information technology and personnel needed to support it.
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 (including in 2025, the PSHBP), 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. It is imperative that the OPM OIG establish a mature data analytics program separate and distinct from any government shared service analytics program.
Program Increase - Inspector General Independence
The OPM OIG’s 2023 budget request outlined the 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 independence as necessary for effective oversight. Congress has continuously prioritized legislation that enhances IG independence. Independence is essential to ensuring the OIG is able to efficiently and effectively audit, evaluate, review, and investigate agency fraud, waste, abuse, and mismanagement.
The OPM OIG operates independently in many areas (e.g., information technology and procurement) but is still heavily dependent on OPM for Human Resources (HR) and Legal Services. As a result, the OPM OIG is bound by OPM’s policies, procedures, and time frames. For example, OPM OIG, like other offices within OPM, procures HR services to recruit and onboard critical personnel for the organization. The requested appropriation will provide the bandwidth to handle OPM OIG matters exclusively with necessary and appropriate urgency.
When HR-related legal needs arise, the OPM’s Office of General Counsel remains the official counsel of record and 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.” While the OPM OIG has a strong working relationship with OPM, it is only one of OPM’s many consumers of HR and Legal Services. Recent process changes have allowed for the OIG counsel to engage in some matters. The OIG is still working toward formalizing a permanent structure where OIG counsel represents the organization independently of the agency. The current arrangement represents a conflict of interest and weakens the OPM OIG’s full 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.
Program Increase - Ensuring Diversity, Equity, Inclusion, and Accessibility (Interns)
In accordance with Section 6 of President Biden’s Executive Order 14035 on Diversity, Equity, Inclusion, and Accessibility (DEIA) in the Federal Workforce, the OPM OIG intends to grow its paid internship program. The OPM OIG program will expand the organization’s current outreach to underserved segments of society by providing opportunities for its participants to build the competencies needed to successfully compete in today’s workforce.
Details of FY 2025 Budget Request
The table below outlines the $6,305,000 increase that the OPM OIG requests for FY 2025 ($236,000 Salaries and Expenses, $6,069,000 Trust Fund Annual).
Program Changes (Increases) | Fund | FY 2025 CBJ (Millions) | FTE | |
---|---|---|---|---|
1. Oversight of the Postal Service Health Benefits Program (PSHBP) | a. Auditors | Trust Fund Annual | $0.759 | 4 |
b. Investigators | Trust Fund Annual | $1.372 | 6 | |
c. Evaluations Program Analyst | Trust Fund Annual | $0.190 | 1 | |
d. Information Technology Specialists | Trust Fund Annual | $0.291 | 2 | |
Total Oversight of the Postal Service Health Benefits Program (PSHBP) | $2.612 | 13 | ||
2. OPM OIG Data Analytics Program | a. Data Scientist / Chief AI Officer | Trust Fund Annual | $0.146 | 1 |
b. Artificial Intelligence and Machine Learning | Trust Fund Annual | $0.376 | 0 | |
Total OPM OIG Data Analytics Program | $0.522 | 1 | ||
3. Inspector General Independence | a. Human Resources Specialist | Trust Fund Annual | $0.191 | 1 |
b. Attorney | Trust Fund Annual | $0.165 | 0 | |
Total Inspector General Independence | $0.356 | 2 | ||
4. Ensuring Diversity, Equity, Inclusion, and Accessibility | a. Interns | Trust Fund Annual | $0.141 | 2 |
Subtotal, FY 2025 CBJ Program Changes | $3.631 | 18 | ||
Total, FY 2025 CBJ Requested Increase | $6.305 | 18 |
The following sections detail the $6,305,000 increase requested by the OPM OIG.
Adjustment to Base
An increase of $2.674 million (42 percent of the requested total increase) will provide for pay adjustments, inflation, and other adjustments to base necessary to maintain the OPM OIG’s current oversight portfolio. Base Adjustments include:
- An increase of $2.0 million to provide for pay increases for non-congressionally confirmed OPM OIG personnel. This includes an assumed federal adjustment effective January 2025 of 2.0 percent and annualizing the January 2024 adjustment of 5.2 percent.
- $0.169 million Salary and Expenses.
- $1.831 million Trust Fund Annual.
- An increase of $0.674 million to account for required inflationary adjustments to employee health benefit contributions.
- $0.067 million Salaries and Expenses.
- $0.607 million Trust Fund Annual.
Program Changes
An increase of $3.631 million (58 percent of the requested total increase) is for program increases, including:
- An increase of $2.612 million for 13 Full Time Equivalents (FTE) is needed by the OPM OIG to ensure the oversight of the development, implementation, and administration of the Postal Service Health Benefits Program within OPM’s Federal Employees Health Benefits Program.
- $0.759 million for 4 Auditor positions to conduct continuous oversight and periodic audits during the development and implementation of the PSHBP.
- $1.372 million for 6 Investigative positions to examine potential procurement fraud, prohibited personnel practices, ineligible member enrollment, or other financial violations such as health care fraud that can occur once the PSHBP begins disbursing benefits.
- $0.190 million for 1 Evaluations Program Analyst to evaluate OPM’s execution of establishing the OPM PSHBP program.
- $0.291 million for 2 Information Technology Specialists to provide routine technical support to include assisting in the management of the audit workpaper and investigative case management software used to support PSHBP oversight work.
- An increase of $0.522 million, including 1 FTE and contract support, is needed by the OPM OIG to fully establish a mature data analytics program separate and distinct from any other shared service analytics programs in government.
- $0.146 million for 1 Data Scientist.
- $0.376 million for Artificial intelligence and Machine Learning system support.
- An increase of $0.356 million for 2 FTEs is needed by the OPM OIG to ensure independence from the OPM OIG parent agency in the areas of Human Resources (HR) and Legal Services.
- $0.191 million for 1 HR Specialist.
- $0.165 million for 1 Attorney.
- An increase of $0.141 million for 2 FTEs is needed to increase paid internship opportunities in the OPM OIG. These positions will expand the organization’s current outreach to underserved segments of society by providing opportunities for its participants to build the competencies needed to successfully compete in today’s workforce.
Additional Reporting Requirements
FY 2025 Budget Request by Object Class
Object Class | FY 2024 Annualized CR | FY 2025 CBJ | Increase/Decrease |
---|---|---|---|
Personnel compensation | $3,251,000 | $3,420,000 | $169,000 |
Personnel benefits | $1,015,000 | $1,082,000 | $67,000 |
Travel and transportation of persons | $22,000 | $22,000 | $0 |
Transportation of things | $0 | $0 | $0 |
Communications, utilities, and rent | $1,773,000 | $1,773,000 | $0 |
Printing and reproduction | $0 | $0 | $0 |
Other services | $847,000 | $847,000 | $0 |
Supplies and materials | $0 | $0 | $0 |
Equipment | $0 | $0 | $0 |
Land and structures | $0 | $0 | $0 |
Total Object Class | $6,908,000 | $7,144,000 | $236,000 |
FTE | 22.0 | 22.0 | 0.0 |
Object Class | FY 2024 Annualized CR | FY 2025 CBJ | Increase/Decrease |
---|---|---|---|
Personnel compensation | $17,226,000 | $21,694,000 | $4,448,000 |
Personnel benefits | $5,777,000 | $7,001,000 | $1,244,000 |
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 | $3,200,000 | $377,000 |
Supplies and materials | $76,000 | $76,000 | $0 |
Equipment | $497,000 | $497,000 | $0 |
Land and structures | $0 | $0 | $0 |
Total Object Class | $29,487,000 | $35,556,000 | $6,069,000 |
FTE | 143.0 | 161.0 | 18.0 |
Budgetary Resources | FY 2023 Enacted $ |
FY 2023 Enacted FTE |
FY 2024 Annualized CR $ |
FY 2024 Annualized CR FTE |
FY 2025 CBJ $ |
FY 2025 CBJ FTE |
Increase/ Decrease $ |
Increase/ Decrease FTE |
---|---|---|---|---|---|---|---|---|
Revolving Fund (Estimated) | $1,545,000 | 7.0 | $1,600,000 | 7.0 | $1,662,000 | 7.0 | $62,000 | 0.0 |
OIG Total (dollars) | $1,545,000 | 7.0 | $1,600,000 | 7.0 | $1,662,000 | 7.0 | $62,000 | 0.0 |
Revolving Fund
For FY 2025, the OPM OIG estimates that $1,662,000 for 7 FTEs 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 Resources Line of Business, HRS Information Technology Program Management Office, Suitability Executive Agent, Credit Monitoring and Identity Protection Services, and Federal Executive Boards.
The following information is provided to adhere to the requirements of the Inspector General Reform Act of 2008 (P.L. 110–498):
Budgetary Resources | FY 2024 Annualized CR $ |
FY 2024 Annualized CR FTE |
FY 2025 CBJ $ |
FY 2025 CBJ FTE |
Increase/Decrease $ |
Increase/Decrease FTE |
---|---|---|---|---|---|---|
OIG Salaries and Expenses | $24,869 | 0.0 | $28,576 | 0.0 | $3,707 | 0.0 |
OIG Trust Funds | $106,153 | 0.0 | $142,224 | 0.0 | $36,071 | 0.0 |
OIG Total (dollars) | $131,022 | 0.0 | $170,800 | 0.0 | $39,778 | 0.0 |
Budgetary Resources | FY 2024 Annualized CR $ |
FY 2024 Annualized CR FTE |
FY 2025 CBJ $ |
FY 2025 CBJ FTE |
Increase/Decrease $ |
Increase/Decrease FTE |
---|---|---|---|---|---|---|
OIG Salaries and Expenses | $14,973 | 0.0 | $14,973 | 0.0 | $0 | 0.0 |
OIG Trust Funds | $218,048 | 0.0 | $272,048 | 0.0 | $54,000 | 0.0 |
Revolving Fund (Estimated) | $6,276 | 0.0 | $6,276 | 0.0 | $0 | 0.0 |
Revolving Fund (Estimated) | $239,297 | 0.0 | $293,297 | 0.0 | $54,000 | 0.0 |
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 Metrics | FY 2022 Result | FY 2023 Result | FY 2024 Goal | FY 2025 Goal |
---|---|---|---|---|
Percentage of Items Completed on Audit Agenda, in accordance with Yellow Book Standards | 100% | 94% | 90% | 90% |
Percentage of Audit Reports issued that meet OIG timeliness and quality guidelines | 90% | 95% | 90% | 90% |
Percentage of investigative cases closed during a fiscal year which resulted in a successful outcome (i.e., criminal action, civil action, or administrative action) | 97% | 91% | 90% | 90% |
Percentage of quality improvement recommendations (revisions to contracts, policies, carrier letters, etc.) accepted by OIG senior staff and referred to stakeholders to mitigate fraud, waste, and abuse | 93% | 91% | 90% | 90% |
Percentage of Suspension and Debarment referrals that are issued within OIG timeliness and regulatory standardsA | NA | 99% | 90% | 90% |
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 2021 Result | FY 2022 Result | FY 2023 Result | |
---|---|---|---|---|
Positive Financial Impact Using Questioned Costs | $72,561,951 | $69,522,235 | $54,709,279 | |
ROI Using Questioned Costs | $2.40 | $2.28 | $1.73 | |
Positive Financial Impact Using Management Commitment to Recover Funds | $48,756,232 | $52,404,850 | $41,958,326 | |
ROI Using Management Commitment to Recover Funds | $1.60 | $1.72 | $1.34 | |
Positive Financial Impact Using Funds RecoveredA | $39,104,805 | $47,929,282 | $26,336,828 | |
ROI Using Funds RecoveredA | $1.48 | $1.61 | $1.26 | |
FEHBP Audit Cycle (in years)B | Experience-Rated Carrier Audits | 15 | 15 | 12 |
Community-Rated Carrier Audits | 17.2 | 15.1 | 18.8 | |
Carrier IT Security Audits | 8.2 | 7.6 | 13.6 | |
Audit Recovery RateC | 43% | 50% | 48% | |
Number of Debarments and Suspensions | 710 | 850 | 935 | |
Number of Debarment and Suspension Inquiries | 4,479 | 3,609 | 2,683 |
Overview of the OPM OIG
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 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. One of the office’s core responsibilities 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. There are approximately 200 insurance carriers participating in the FEHBP with annual premium payments that exceed $50 billion. In addition, we conduct audits of OPM's Retirement Program, which has over $1 trillion in net assets available for benefits and makes monthly payments to almost 3 million annuitants and survivors which exceed $80 billion annually. 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 Office of Management is responsible for managing OPM OIG functions related to information technology (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 developing an advanced data analytics program to support the OIG’s 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 the office and is responsible for suspending and debarring from participation in the FEHBP health care providers who have committed various criminal and professional violations.
Footnote A
New Measure
Footnote A
New Statistic
Footnote B
An audit cycle measures the frequency of completed audits of carriers or other auditees in an audit universe. For FEHBP carriers, regulations require that they maintain documentation supporting rates and costs for 6 years. The target audit cycle for these carriers is based on this and the realization that the older the information is that the OPM OIG is trying to audit, the less efficient the audit will be.
Experience-Rated Carrier Audits was a 7
Community-Rated Carrier Audits was a 5
Carrier IT Security Audits was a 6
Footnote C
The audit recovery rate represents the percentage of questioned costs from audit reports that are ultimately recovered and returned to the FEHBP Trust Fund (a small percentage of questioned costs may relate to other programs). The recovery rate presented is a 5-year average, but because it is not unusual for the audit resolution process of the agency to take multiple years, the reported rate is based on incomplete information.