The U.S. Coast Guard’s Travel to Obtain Health Care program is intended to ensure U.S. Coast Guard (Coast Guard) members and their dependents have access to proper medical care while stationed in locations where access to specialty care may not be readily available. From October 2010 through June 2014, the Coast Guard spent almost $4.5 million on this program. We received allegations that unnecessary travel had been approved. As a result, we conducted this audit to determine if the program has sufficient controls to ensure travel is necessary. The program did not have sufficient controls to ensure that travel for medical purposes was necessary. The Coast Guard did not establish, distribute, or ensure implementation of clear policies and procedures for reviewing, approving, and maintaining program requests. Local offices were not provided criteria or training on how to evaluate the requests, did not document that travel was necessary, and did not adequately justify that the location for medical care was appropriate. Ninety-four percent of the records tested were missing essential information, such as physicians’ referrals and cost estimates. Without this information, approving officials may not have been able to evaluate whether the travel was necessary and cost effective. As a result, the Coast Guard may have approved requests for inappropriate health care travel, incurring unnecessary costs and lost productivity.