Report: VA’s Health Enrollment Backlog Includes 300K Deceased Vets

More than 300,000 veterans listed as actively trying to enroll in the Department of Veterans Affairs' health care program are in fact deceased, according to a VA Office of Inspector General report released Wednesday, the Washington Times reports (Shastry, Washington Times, 9/2).

Background

The House Veterans' Affairs Committee requested the investigation after a whistleblower brought the issue to light (Kime, Military Times/USA Today, 9/2).

When the Veterans Health Administration enrollment system was established in 2009, it incorporated all existing records at that time. However, workers did not confirm whether the records were still active, which meant information from deceased veterans was added to the system, according to the Times (Washington Times, 9/2).

Report Details

According to the report, VHA's enrollment system one year ago had roughly 867,000 "pending" records. VA's OIG found that about 35% of the pending claims were for veterans who investigators determined were deceased (Muchmore, Modern Healthcare, 9/2). The report cautioned that "data limitations" prevented investigators from ascertaining the number of now-deceased veterans who applied for benefits and when such veterans had applied. More than 50% of applications labeled as pending as of last year lack application dates, meaning VA OIG "could not reliably determine how many records were associated with actual applications for enrollment," according to the report (Daly, AP/Time, 9/2).

Further, system deficiencies also prevented VA OIG from determining how many of the pending records were for health care benefits (Washington Times, 9/2).

In addition, VA OIG found that VA wrongly labeled several thousand unprocessed applications as completed (AP/Time, 9/2). Further, the report found that about 10,000 claims records had been deleted without first being processed (Washington Times, 9/2). According to the report, investigators could not definitively rule that the data had not been manipulated (Modern Healthcare, 9/2).

The report concluded, "Overstated pending enrollment records create unnecessary difficulty and confusion in identifying and assisting veterans with the most urgent need for health care enrollment," adding, "Additionally, outreach efforts to obtain additional information for enrollment eligibility may have been frustrating and upsetting to family members of deceased veterans" (Washington Times, 9/2).

Report Recommendations

VA OIG suggested that VHA:

• Designate an official to head efforts to oversee efforts to correct the issues;
• Determine how to prevent veterans' applications from being deleted prior to being processed;
• Establish a time limit for how long an application can be pending;
• Set a process for verifying when those in the system have died (Washington Times, 9/2); and
• Assign a senior official to implement a multiyear correction plan to fix data integrity issues and identify veterans with pending applications.

According to Modern Healthcare, VHA and the Office of Information and Technology submitted such correction plans that included:

• Software changes;
• Changes to how an applicant's pending status can be updated; and
• The creation of working groups to recommend additional improvements.

Further, the report recommends that VHA and OIT determine whether any senior officials should be subject to administrative action.

Reaction

VA Undersecretary of Health David Shulkin in a response to the report said VA "regret[s] the inconvenience and potential hardship place[d] on applicants for health care and [is] working hard to restore veterans' confidence and trust in VA's systems and staff." He added that VA has "and will continue to take timely and appropriate steps to improve [its] services to ensure [it] meet[s] the expectations of those whom [it] has the honor of serving."

In addition, VA in a statement said it "continues" previously outlined "efforts ... to contact veterans with a record in a pending status ... to determine if they desired to enroll in VA health care" (Modern Healthcare, 9/2).

Meanwhile, Senate Veterans' Affairs Committee Chair Johnny Isakson (R-Ga.) and Sen. Richard Blumenthal (D-Conn.) in a joint statement said, "The findings ... point to both a significant failure on behalf of past leadership at the Health Eligibility Center and deficient oversight by the VA central office." They added, "We urge the VA to implement the inspector general's recommendations quickly to improve record keeping at the VA and ensure that this level of blatant mismanagement does not happen again" (Washington Times, 9/2).