Thursday, December 18, 2014

Inspector General Admits that VA Reports are Wrong

VA Misled Congress on Its Own Audit, Watchdog Report Finds

Veterans Department Provided Incorrect Information About a Review of Unresolved Appointment Requests
House Committee on Veterans’ Affairs Chairman Jeff Miller said lawmakers may never know the actual number of veterans affected by gaps in the VA system.

House Committee on Veterans’ Affairs Chairman Jeff Miller said lawmakers may never know the actual number of veterans affected by gaps in the VA system. Associated Press By Ben Kesling

Dec. 16, 2014 4:05 p.m. ET

The Department of Veterans Affairs provided misleading or false information to Congress and the media multiple times this summer about a year-plus review of unresolved patient consultation requests, according to an internal watchdog’s report issued Monday.

The VA’s inspector general said the department misled or provided incorrect information earlier this year about an audit of unresolved requests for consultations with specialists. Some of those requests remained open for years, and some patients died while waiting for appointments. The scope of the VA audit was overrepresented, the inspector general said, and the ultimate resolution for millions of those consults remains unknown.

The Veterans Health Administration “lacks reasonable assurance that facilities appropriately reviewed and resolved consults,” the inspector general wrote in the report. “At one medical facility, consults were inappropriately closed while veterans were awaiting requested services in an effort to meet VHA’s early May 2014 deadline for reviewing and responding to unresolved consults. Similar events may have occurred at other VA facilities.”

In the VA’s response to the findings, Carolyn Clancy, VA interim under secretary for health, said the department agrees with all of the inspector general’s findings and aims to resolve them by mid-2015.

The review stems from a 2012 initiative by the VA to resolve a backlog of consult requests that had accumulated since 1999, when the department instituted a new system for health-care providers to request advice or expertise of a specialist in treating patients. By 2012, the system was bogged down by more than two million unresolved requests, including rescheduling appointments and ordering basic tests—things the system wasn’t designed to include.

The VA told Congress and the media that it instructed its medical centers in 2012 to review all consults unresolved for more than 90 days and to complete all reviews by May 2014. According to the VA, the number of backlogged consults dropped from two million to just under 300,000 by April 2014.

“These internal, proactive reviews were conducted with the express purpose of improving veteran care,” a VA spokesman said in a statement Tuesday. “VA is committed to keeping all of our stakeholders, including members of Congress, accurately informed.”

But according to the inspector general’s report, the VA didn’t routinely use internal quality controls to determine how or why employees closed some 1.7 million cases, or if patients received requested services before the cases were closed out. The VA also told reviewing authorities that they could close cases that were more than five years old without reviewing them.

The inspector general also found errors in a fact sheet the VA presented to the House Committee on Veterans’ Affairs in April. In it, the VA incorrectly reported it had reviewed unresolved consults going back to 1999 and that it said the “vast majority” of unresolved consults were due to paperwork problems rather than true delays in care—a statement the VA cannot now verify.

“VA inadvertently caused confusion in its communication on this complex set of reviews that were ongoing at the time,” said a VA spokesman in his statement Tuesday. ”While all open consults were identified going back to 1999, based on subject matter expertise and recommendations, facilities were given the option of administratively closing consults greater than five years old, as consults may be beyond a clinically significant time frame or are outdated and are no longer relevant to the patient’s care.”

The inspector general recommended the VA conduct an assessment of its review program and confirm patients received adequate care as well as take “appropriate administrative action” after reviewing “any inappropriate resolution of consults.”

“VA’s statistics regarding the number of veterans harmed by department delays in care are almost certainly wildly inaccurate, and we may never know the actual number of veterans affected by gaps in the VA system that existed for years,” said Rep. Jeff Miller (R., Fla.), chairman of the House Committee on Veterans’ Affairs in a statement Tuesday.

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