By Ethan Faverino |
Congressman Paul Gosar (R-AZ-09) is calling on the Department of Veterans Affairs (VA) to implement recommendations from a recent Office of Inspector General (OIG) audit that found widespread failures in the administration of the Veterans Community Care Program (VCCP), including improper eligibility determinations, inadequate documentation, and hundreds of millions of dollars in unnecessary spending.
In a letter to VA Secretary Doug Collins and Acting Under Secretary John Figueroa, Gosar urged the department to fully implement the OIG’s recommendations to improve accountability and ensure veterans receive the care they are entitled to under federal law.
The audit, released by the VA Office of Inspector General on June 17, was mandated by the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvement Act.
It examined whether the Veterans Health Administration (VHA) accurately identified veterans eligible for community care and properly informed them of their options under the VA MISSION Act.
The OIG concluded that the VA was “not effectively identifying and informing all eligible veterans about all their care options within and outside VA.”
Investigators found that some veterans who qualified for community care were never informed of their eligibility, while others who did not qualify were improperly referred to outside providers.
According to the audit, nearly one in four community care referrals—approximately 340,000 of 1.4 million consults reviewed during the first quarter of FY25—were made even though veterans did not meet eligibility requirements.
At the same time, an estimated 1.8 million veterans who received care through VA facilities lacked documentation showing they had been evaluated for community care eligibility, with more than one million cases containing no evidence that veterans had voluntarily declined the option.
The OIG estimated that inaccurate eligibility determinations resulted in approximately $440 million in unnecessary spending during the first quarter of FY25 alone. If those issues continue unaddressed, the agency estimated the cost could reach $1.7 billion annually.
The audit attributed many of the problems to inconsistent guidance from the VA’s Office of Integrated Veteran Care, scheduling system limitations that prevented staff from viewing appointment availability across all VA facilities, and a lack of access to community care scheduling data needed to help veterans make informed decisions.
Investigators also found that some veterans referred to community care could have received treatment sooner through VA facilities, while others who qualified for community care were never informed of that option.
The report warned that these shortcomings not only waste taxpayer dollars but also risk delaying medical treatment for veterans by preventing them from accessing the care options that best meet their needs.
The Office of Inspector General issued six recommendations aimed at improving the effectiveness of the Veterans Community Care Program.
The Veterans Health Administration concurred with five recommendations and concurred in principle with the sixth, submitting corrective action plans intended to address the findings.
In his letter, Gosar encouraged Secretary Collins to work with Congress to fully implement the OIG’s recommendations, strengthen oversight of the Veterans Community Care Program, and ensure it is administered with the diligence and integrity America’s veterans deserve.
Ethan Faverino is a reporter for AZ Free News. You can send him news tips using this link.
