A report on the VA’s enrollment system identifies major deficiencies that have affected thousands of veterans’ access to health care.
The Office of Inspector General’s report says that the Veterans Health Administration failed to “provide effective governance necessary to ensure oversight and control over the health care enrollment program at its medical facilities.”
Eligibility is based on military service and financial need and can be processed online, through the mail, by telephone or in person at a VA medical facility.
The report examines enrollment activity at medical facilities from October 2014 to September 2015. The audit was conducted from December 2015 to May 2017. Topeka-based Matt Eitutis was acting director of Member Services, which oversees enrollment, from January 2016 to May 2017. He is now the director of enterprise support services within Member Services, according to VA press secretary Curt Cashour.
“The acting executive director of VHA’s Member Services Division acknowledged that they did not review enrollment procedures or otherwise monitor the health care enrollment process nationwide,” the report found.
It also identified a lack of formal training for enrollment staff at VA medical facilities.
At some hospitals, enrollment information wasn’t entered into the VA’s system.
“By not entering the applicant’s information, enrollment staff delayed, or in some instances, may have inadvertently prevented obtaining available evidence to validate the applicant’s eligibility for VA health care,” the report said.
Dan Caldwell, policy director with Concerned Veterans for America, said veterans should have the option to use their benefits with providers outside the VA network.
“Some of the VA’s outdated and inefficient processes can lead to delayed care,” he said. “Veterans deserve the ability to seek care outside of the department if they are not being seen in a timely manner.”
Some applications were closed or made ineligible after 30 or 90 days instead of the federally mandated 365 days. Additionally, the report identified problems with the VA’s enrollment data system which wasn’t able to accurately track performance and in some cases, didn’t have the necessary timestamp to evaluate the time between an application’s receipt and entry into the data system.
The audit also determined that of the 106 facilities sampled, 38 had established local enrollment policies. Where local policies were in place, they often conflicted with national policies.
While it acknowledges several improvements to the enrollment program, it notes that as of mid-June, more than 658,000 applications remained in a pending status.
The report concludes that the enrollment process wasn’t “veteran-centric” and couldn’t “ensure all veterans are provided equal treatment when applying for enrollment.”
The report also mentions another ongoing audit involving the accuracy of 440,000 letters that were sent to veterans in a pending status in December 2016. The letters may have requested the wrong information needed to complete enrollment.
Cashour said the VA isn’t closing those legacy pending applications due to the ongoing OIG review.
An internal VA email obtained by The Capital-Journal suggests that administrators were in the process of rolling out 400,000 to 500,000 application closure letters earlier this month.
Initially Cashour said the letters weren’t related to the legacy pending applications. He then said they were in reference to the applications, but that they were notifications that give veterans another year to respond and complete their enrollment.
However, internal VA correspondences refer to them as “closure letters.”