VA Sets July Deadline for Punishments over Patient Appointment Fraud

OFF THE WIRE

by Bryant Jordan

The Veterans Affairs Department has set a July deadline for recommending administrative or disciplinary action against any employee who manipulated patient appointments, including those that caused delays leading to veteran deaths.
The VA's pledge to hold personnel accountable for delays is included in a recent Inspector General report that confirmed that the VA gave Congress incorrect information on the number of deaths associated with delayed care.
The VA said in April that 23 veterans died and another 76 suffered harm awaiting care, based on reviews going back to 1999. In fact, the reviews only went back to 2007.
"As this report makes clear, VA simply closed out consults that had been unresolved for more than five years en masse and without proper review," Rep. Jeff Miller, R-Florida, said in a statement on Tuesday. "That makes the repeated assertions from multiple VA leaders that the department's review dated back to 1999 undeniably false."
It also leaves open just how many veterans did die or grew more sickened while awaiting care.
"We may never know the actual number of veterans affected by gaps in the VA system that existed for years," Miller said.
Miller is also concerned with VA's findings the number of delayed appointments lasting longer than 90 days dropped from 2 million to fewer than 300,000 from 2012 to 2014.
Since the IG found that the VA was not able to document how its employees were closing out the appointments, it could not ensure the accuracy of the numbers.
The VA concurred with three recommendations made in the IG report, including reviewing the circumstances of inappropriate delays in care to determine if administrative action is warranted.
Where they are, the VA will confer with its Office of Human Resources and VA General Counsel "to determine appropriate administrative actions." These could include further administrative investigations and disciplinary actions, the VA said.
Lawmakers and veterans groups have been demanding the firing of VA personnel responsible for appointment delays, especially those linked to deaths of veterans.
Many have been frustrated and disappointed in recent months since Congress passed legislation that, many believed, would make it easier for VA Secretary Bob McDonald to fire employees, including senior executive service-level officials.
Beyond changing the appeal period for a firing, however, the law did little else. McDonald said employees still have the right to due process before being terminated.
The VA also agreed with IG recommendations that it assess the process each VA medical facility used to address delayed appointments for the review that was the basis of the numbers given to Congress. VA said it would have this done by February.
If the VA determines that the process was flawed, the IG recommended the department take steps to confirm that patients did subsequently receive care.
The VA said it would complete this by May.
The VA said it did not deliberately mislead Congress, either in the number of veterans who died because of delays or over the period it claimed to review.
"While all open consults [delayed appointments] were identified going back to 1999 ... facilities were given the option of administratively closing consults greater than five years old," Hutton said in the statement on Tuesday. These appointments may have been "beyond a clinically significant timeframe or are outdated and are no longer relevant to the patient's care."
"VA is committed to keeping all of our stakeholders, including members of Congress, accurately informed," he said.

-- Bryant Jordan can be reached at bryant.jordan@monster.com