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#VAFail – Audits show Choice Program payment errors costing millions

By Concerned Veterans for America

#VAFail – Audits show Choice Program payment errors costing millions

Inspector General for the Department of Veterans Affairs (VA) Michael Missal sent a letter to VA Secretary David Shulkin last week outlining audit findings into payments made under the Veterans Choice Program. The shortened version: it’s not going well.

The OIG is currently in the process of completing two audits, with a third audit to follow, based on changes to the payment process over time since the Veterans Choice Program was implemented. In the first audit, the OIG has found a list of payment problems including duplication of payments and payment rate errors. OIG attributes this to a “lack of an appropriate payment process for Choice claims and an ineffective internal control system for that payment process.” In a two-year period, the Office of Community Care overpaid third-party administrators by tens of millions of dollars.

The second audit of a new payment process found “tens of thousands of duplicate payments.” TriWest, one of VA’s third-party administrators, found “approximately 58,000 claims that had been improperly paid, representing a total of approximately $35 million in overpayments by VA to TriWest [$28 million of which was attributed to Choice payments].”

Missal concludes that “making accurate and timely payments in the Choice Program has proven to be a significant challenge for the VA, and…identified payment errors total in the tens of millions of dollars.” Payment errors have cost the VA tens of millions of dollars, meanwhile the Choice Program just needed emergency funding to keep it afloat.

This report is not surprising given the VA’s lack of proper management and oversight. It serves to underscore the systemic problems in the Veterans Choice Program and the need for an overhaul of the program altogether.