Appendix A – Audit Criteria and Methodology

Appendix A – Audit Criteria and Methodology
Objective Criteria
To provide assurance that the Federal Health Claims Processing Services contract is appropriately administered including management of the contract, the receipt and acceptance of deliverables, and the monitoring of financial performance.
  1. VAC Contract Administration Unit (CAU) monitors the contract in a manner that ensures it is successfully executed in accordance with the agreed terms of the contract.
  2. Authority, responsibility and accountability for contract administration are clearly defined and communicated.
  3. Formal communication processes/mechanisms exist and support sharing of timely, relevant and reliable information.
  4. VAC CAU has processes and practices to ensure change initiatives are properly implemented.
  5. Management identifies the risks that may preclude the achievement of its objectives.
  6. VAC CAU has mechanism(s) in place to validate/accept required key deliverables.
  7. VAC CAU has mechanism(s) in place to address issues of non-compliance with key contract deliverables.
  8. Amounts for goods and services received are accurate and approved by a delegated authority.
  9. Reviews are conducted to analyze, compare, and explain financial variances between actual and planned.
Methodology Purpose
Interviews Interviews were conducted with various stakeholders (VAC staff, 3rd party processing staff, contract authorities, partner organizations, and senior management) to discuss governance, controls, risk, and challenges related to the management of the FHCPS contract.
Direct Observation Direct observation of two quarterly partner meeting, which include partner organizations and the contractor, were conducted to assess communication processes and procedures.
Documentation Review Documentation was reviewed to determine the administration and governance of the FHCPS contract. Documents were also reviewed in regards to the authorities over the contract and the monitoring of financial performance.

Documents related to the financial approval of invoices were reviewed to determine whether appropriate verification was conducted.

VAC CAU analysis documentation was reviewed to ensure variances/issues are addressed related to projected contract costs.
 
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