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Veterans seeking health care at military bases encounter delays at security gates, access problems with medical records and slowdowns with billing and reimbursements, according to a federal watchdog report. (Government Accountability Office)

WASHINGTON — Veterans seeking health care at military bases encounter delays at security gates, access problems with medical records, and slowdowns with billing and reimbursements.

A new report by the Government Accountability Office describes the common obstacles veterans encounter at clinics on military bases.

The Department of Veterans Affairs and the Defense Department share medical services at some installations with the goal of improving patient access to timely medical care.

The GAO submitted a report June 30 to the House Veterans’ Affairs Committee that looked at “sharing agreements” between the VA and Defense Department for referring veterans and active-duty service members to facilities and services each department runs.

“While sharing agreements can improve access in many cases, that hasn’t been true for all. Some issues include veterans’ inability to access some military bases, incompatible electronic health records systems and differing billing practices,” the report said.

The report found veterans can face barriers and have waits before they are allowed to enter medical clinics on military bases because of security protocols. While going through security checks is standard, the process slows down veterans with scheduled medical appointments.

Veterans also have problems sharing their digital VA health charts with military doctors.

The Defense Department and VA have “incompatible” health records systems, and their billing processes differ, which slow the delivery of reimbursements, according to the report.

“For example, officials at one site told us that staff often have to document patients’ medical records separately in the two departments’ electronic medical records systems. This has increased the risk of errors and frustrations for staff,” according to the report.

There also were reported instances of payment delays for medical claims submitted by the Defense Department.

“One official told us that DOD limited the number of VA referrals accepted because it wasn’t being reimbursed for the services provided,” according to the report.

The Defense Department’s national billing office found the VA owed more than $87 million for medical services provided for fiscal years 2018 through 2022, according to the report. The VA paid a settlement of more than $76 million on those claims in 2024.

The VA operates 170 medical centers, and 1,200 clinics. The Defense Department has nine medical centers, 36 hospitals, 525 clinics and 138 dental facilities worldwide.

Sharing agreements between the two departments enable veterans to access select medical services at facilities run by the Defense Department when the services are unavailable at their VA facility or cannot be provided in a timely manner, according to the report.

“Some sharing agreements may also be set up to allow service members to access select medical care services at a VA facility,” the report said.

The sharing agreements included 77 VA facilities, and 98 facilities run by the Defense Department, according to the report.

Under certain sharing agreements, staff might work at VA and Defense Department facilities.

“Officials at one site told us their cardio-thoracic surgery sharing agreement allowed DOD surgeons from the DOD facility to use the VA facility’s operating room once a week to treat veterans,” the report said.

At another site, the Defense Department shared a portion of its dental clinic on a military based with the VA.

Sharing agreements also deliver lower costs for medical services, the report said.

“These agreements enable expanded access to specialty care for both veterans and service members at a cost typically 20% lower than what the departments would pay for comparable care from civilian or community providers,” the report said.

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Linda F. Hersey is a veterans reporter based in Washington, D.C. She previously covered the Navy and Marine Corps at Inside Washington Publishers. She also was a government reporter at the Fairbanks Daily News-Miner in Alaska, where she reported on the military, economy and congressional delegation.

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