The VA OIG report — Veterans Health Administration Review of Alleged Mismanagement at the Health Eligibility Center — discusses several issues VA has publicly acknowledged to Veterans, Veterans Service Organizations and members of Congress: that our enrollment system management, data integrity and quality are in need of significant improvement.
We have worked hard over the past year to address those issues. VA appreciates the work of the OIG and is working diligently to address the issues their report raised to better serve Veterans. We realize the issues raised about our enrollment process are confusing to Veterans and our stakeholders. It is critical for Veterans and our stakeholders understand what this report says, and what it does not say.
Some news media stories based on the report’s findings claim that “over 300,000 Veterans died waiting for care.” That conclusion is not supportable by the information in the report.
The OIG found 307,000 out of the over 800,000 pending enrollment system records were for individuals the reported as deceased by the Social Security Administration, and that VA OIG could not determine specifically how many pending records represent Veterans who applied for health care benefits or when they may have applied. This was because of data weaknesses within our system which we are working hard to improve. The VA OIG report further determined that many of the 867,000 records coded as pending do not represent Veterans actively seeking enrollment in VA health care.
These stories, similar to the stories over the past year regarding pending records in our enrollment system, wrongly link these pending records with access to care issues for fully enrolled Veterans that have chosen to use, and who are receiving, VA healthcare. They are separate issues. Although VA has repeatedly pointed this out to inquiring media, several media stories and commentary continue to appear with this incorrect information.
Additionally, it is not correct to assume, whether an enrollment application record is complete or not, that all Veterans want to use VA care. Veterans can, and do, choose other healthcare options. For example Veterans who are military retirees can, and do, choose to use TRICARE.
As we have previously stated publicly, VA currently has no authority to move records from a pending status even after VA attempts to contact a Veteran, and the Veteran has not provided financial information or military records required by law to determine eligibility.
There are also situations in which a Veteran’s record transfers to our enrollment system even though the Veteran likely did not apply for enrollment. One example is when Veterans in the past applied for State Home benefits.
The pending enrollment records population also includes records of Veterans had accessed our health care system in some fashion before the congressionally mandated implementation of the current VA health care enrollment process in 1998.
Current regulatory guidelines prohibit us from removing these records, resulting in VA leaving them in a pending status. We retained all of those records with full knowledge that some records are likely not applications for enrollment for health care and some records include Veterans that have passed away, as some of the records go back decades and would put many Veterans’ age at over 100 years.
VA is pursuing several remedies to clean up the enrollment records system. Those changes include revamping deceased Veteran verification processes and regulation changes to not only make it easier to remove incomplete enrollment records from the pending file, but also provide continued opportunities for Veterans to reapply for healthcare enrollment at any time.
If any issues raised in the report require additional review and accountability actions, VA will act as necessary and pursue them and afford all concerned appropriate due process.
VA continues the efforts outlined in previous blogs and public responses to contact Veterans with a record in a pending status (irrespective of whether an application date is present) to determine if they desired to enroll in VA healthcare.
As of July 31, 2015, VA has contacted 310,818 Veterans asking them to submit required documents and has received 36,749 responses, with 34,517 Veterans receiving enrollment decisions of which 25,784 were enrolled. As we continue our work to contact Veterans, our focus remains on improving the enrollment system to better serve Veterans.
Caring for our nation’s Veterans is the highest honor and privilege for the men and women who serve them at the VA. That is a responsibility that we do not take lightly. It is important that we openly discuss how we intend to improve. Our focus remains on improving the enrollment system to better serve Veterans. We continuously share information on enrollment processes with Network Directors and our partners in the Veterans Service Organizations.
About the author: Janet P. Murphy, MBA serves as the Acting Deputy Under Secretary for Health for Operations and Management for the Veterans Health Administration.