Child porn, wait times and close to $1 billion wasted at VA

Jonathan Kaupanger
May 31, 2018 - 2:17 pm

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More than half of VA’s new patients are waiting over 30 days for their first appointment. Choice is running out of money, maybe that’s because of the almost $40 million in overpayments. Not to mention there’s been drug diversion and child porn. And that’s just in the last six months too!

Twice a year, Congress receives information on exactly what’s going on at VA. This detailed material comes from the VA’s Inspector General and almost reads like a gossip column at times, just without names. 

It also gives us a look at the health of the second largest government agency.

Wait times and wasted money

When a veteran first goes to see a VA doctor they are assigned to a Primary Care Panel. This is so they can see familiar faces every time they have an appointment. Since 2015, these panels have seen 13 to 30 percent fewer veterans than they should. As a result, Veterans Health Administration (VHA) employees are underused, but still receive full salary. If this doesn’t change, by 2020 the VA will have wasted $843 million on these salaries.

During this investigation, it was discovered that VHA doesn’t track the wait time from the day a veteran is enrolled into the VA system until the date of their first appointment. VHA reports only eight percent of newly enrolled vets have to wait more than 30 days for appointments. If you add in the correct data, including enrollment dates, the actual number of waiting veterans is 53 percent.

Choice and pension overpayments

On paper, the Choice Program should be simple, but obviously it’s not. After a veteran sees a medical provider outside of the VA system, the VA is supposed to pay that bill within 30 days. This doesn’t always happen. Because of what the IG says is weak internal controls, 224,000 claims were paid in error.  That’s $39 million in overpayments. The inspectors actually took samples from two million claims and found that half of the claims didn’t even get processed within the 30 day period, which is required by law. 

The weak internal process is partly due to the fact that VHA’s Office of Community Care – the office that runs Choice – doesn’t actually have a written policy for Choice claim payments.

VA pensions are paid out of three locations in the country.  If you live in a state that is served by the St. Paul Regional Office, you were more likely to have your claim denied. About 88 percent of the St. Paul claims were denied because management didn’t fully understand VBA guidance.  Medical exams just weren’t requested so required medical evidence wasn’t available.  Even if you took out all of the claims with missing exams the St. Paul office was more likely to deny claims when compared with the other two offices.

To make things worse, if a veteran lived in a Medicaid covered nursing facility, claims from all three processing centers were delayed and inaccurately processed. Out of 2,800 cases reviewed, problems were discovered in 1,900 claims. With pension overpayments, if things don’t change soon the Veterans Benefits Administration (VBA) will pay just about $34.5 million worth of improper payments by 2020.

Criminal cases

Tramadol is a very serious drug. That didn’t stop a CBOC employee in Florida from changing the addresses of 19 veterans to her own address. She then called and ordered refills for the patients. The end result was a diversion of 28 shipments of tramadol which is a total of 4,020 pills.  Once she received the pills, she went back into the computer system and changed the address back. She is no longer a VA employee.

A Peer Support Specialist is supposed to help people who struggle with mental health, psychological trauma and substance abuse. One at a VA facility in Wisconsin decided it was ok to text inappropriate pictures, grope and have sex with some of his female patients. The now former VA employee was convicted of sexual exploitation by a therapist and can no longer work in any capacity in mental health or substance abuse treatment.

In Kansas, a former VA physician assistant was sent to jail for 15 years after being convicted of aggravated criminal sodomy, aggravated sexual battery and sexual battery after he admitted to over-prescribing narcotic medication and giving unnecessary and excessive genital exams to multiple male patients.

Child pornography and child sexual activity

In Texas, a veteran was indicted and arrested after using a VA network to access an email account that contained child pornography.  In Ohio, a former VA employee was sentenced to 53 months incarceration after it was discovered he used electronic devices, including his VA issued computer, to lure an underage female for sexual activity. He also traveled interstate to have sex with another 15-year-old girl.

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