WASHINGTON — The Department of Veterans Affairs doesn’t have the tools to track whether private-sector medical providers are accurately giving exams that help determine whether veterans are eligible for VA benefits, a government watchdog agency found.
Disability compensation exams are key in determining whether veterans have injuries or illnesses connected to their military service and deserve compensation. Because of legislation passed in 2014 that allows the VA to outsource more services, an increasing number of veterans are receiving their exams outside of the agency.
The Government Accountability Office reported last week that the VA lacks the data to determine whether the private-sector providers are meeting standards for quality, timeliness and accuracy. Based on analysis by the GAO, the contractors are falling short with the exams.
“As VA continues to rely on contracted examiners, it is important that the agency is well positioned to carry out effective oversight of contractors to help ensure that veterans receive high-quality and timely exams,” the GAO report states.
The report is expected to be the subject of a House subcommittee hearing Thursday.
Rep. Phil Roe, R-Tenn., the chairman of the House Committee on Veterans’ Affairs, asked the GAO to conduct the investigation. “If Congress is without data on the quality and timeliness of these examinations, we have no way of knowing if this is wise use of taxpayer funds,” Roe said Friday in a statement. “I remain just as committed as I was when I first became chairman to ensuring that veterans are receiving timely and quality examinations and that taxpayer money is well spent.”
The VA awarded contracts in 2016 to five private firms to conduct the exams, totaling up to $6.8 billion for five years. The firms are: VetFed Resources, Inc., in Alexandria, Va.; Logistics Health Inc., in La Crosse, Wisc.; Medical Support Los Angeles in Pasadena, Calif.; QTC Medical Services, Inc., in Diamond Bar, Calif., and Veterans Evaluation Services, Inc., in Houston, Texas.
When awarding the contracts, then-VA Secretary Robert McDonald said it was good news for veterans who were waiting for the VA to determine whether they were eligible for VA benefits – a process that can take years. “For these veterans, we want the process to be smoother – from beginning to end,” McDonald said in a statement at the time.
The GAO focused its investigation on 2017, when contractors conducted 767,000 disability compensation medical exams – about half of the total exams that year. The cost of the exams by contractors totaled $765 million.
The VA set standards for the outside contractors to meet, including for 92 percent of exam reports to contain no errors. In the first half of 2017, only one contractor met that target, the GAO found.
Most contractors fell into the “unsatisfactory performance” category, meaning 10 percent or more of their reports contained errors. The worst-performing contractor had errors in 38 percent of their exam reports.
The VA doesn’t have data for the second half of 2017, but the agency said it hired more staff to review the quality of the reports.
The department had even less information about how quickly the exams are being performed. Contractors are supposed to send their exam reports to the VA within 20 days after they accept a veteran’s exam request. The VA lacked the tools to determine whether they met that mark.
Using VA data, the GAO investigators themselves analyzed the timeliness of 646,005 exams that contractors completed between February 2017 and January 2018. Of those exams, 306,479 – just more than half – were completed within 20 days. Twelve percent, 69,748 claims, took 40 days – double the targeted time.
Contractors gave various reasons for the delays, including severe weather, veterans’ availability and challenges finding medical specialists in rural areas.
As of June 2018, there were more than 87,000 exams pending with contractors. Of those exams, 37,077 had already lapsed beyond the 20-day target, the GAO reported.
“Tracking these exams is important because a large volume of such exams could ultimately increase the amount of time veterans have to wait for their claims to be processed,” the report states.
The GAO made four recommendations to better track and analyze the contractors’ performance. Investigators also recommended the VA improve its training for the providers who conduct disability compensation exams.
In response to the report, VA Secretary Robert Wilkie wrote the VA was developing a new system to capture and analyze data from the exams, which is expected to be completed by the end of the year.
The department is also trying to hire employees who could implement a new training plan for outside medical providers. The House subcommittee on disability assistance and memorial affairs is scheduled to meet at 10:30 a.m. Thursday to discuss the report. “It is time to delve into the details,” Roe said.