Memo Shows VA Aware of Illegitimate Waiting List Practices in 2010

May 22, 2014 in News

During a Senate Veterans Affairs Committee hearing last week, lawmakers cited a memo that showed the agency was aware as early as 2010 that Department of Veterans Affairs health clinics were inappropriately using electronic health record systems to facilitate improper scheduling practices, the Washington Post‘s “Federal Eye” reports (Hicks,” Federal Eye,” Washington Post, 5/20).

Background

Last month, Sam Foote — a retired physician formerly at the Phoenix VA Health Care System — claimed that employees at the practice inaccurately used the center’s EHR system and “deliberately” created a secret waiting list to hide documentation of delays in care, which allegedly led to nearly 40 U.S. veteran deaths. According to Foote, up to 1,600 patients were placed on a secret electronic waiting list at the Phoenix center, sometimes waiting months to over a year to have an appointment scheduled.

Current VA rules state that patients who contact veterans’ health centers for an appointment should be seen within 30 days of their request.

In recent weeks, similar allegations have been made about VA facilities in Texas, Colorado and other states (iHealthBeat, 5/19).

Memo Details

During the hearing, Sen. Johnny Isakson (R-Ga.) questioned former VA Undersecretary for Health Robert Petzel about a memo that summarizes at least 17 strategies that the agency’s health care clinics were known to have used to conceal delays in patient treatment. The strategies included:

  • The use of a log book or manual system to record appointments instead of the agency’s electronic waiting list;
  • Using the auto-rebooking tool, which removes critical patient data;
  • Entering a patient’s appointment date into the wrong slot;
  • Failing to enter or incorrectly entering desired appointment dates; and
  • Failing to link consults to a patient’s scheduled appointment (“Federal Eye,” Washington Post, 5/20).

Petzel resigned from his position on Friday, one day after the hearing (iHealthBeat, 5/19).

According to “Federal Eye,” a VA executive in the memo cautions the directors of all VA health networks that such inappropriate scheduling practices would “not be tolerated” (“Federal Eye,” Washington Post, 5/20).

Senate Committee Moves To Block VA Bonuses, Help Investigation

Meanwhile, the Senate Appropriations subcommittee charged with overseeing VA on Tuesday approved a FY 2015 Military Construction and Veterans Affairs bill that would bar performance bonuses until an investigation into the waiting lists is complete, The Hill reports (Wasson, The Hill, 5/20).

Specifically, the bill would bar performance bonuses for the VA Health Administration’s:

  • Medical directors;
  • Assistant medical directors; and
  • Senior executives.

In addition, the bill would grant the VA inspector general’s office an additional $5 million to examine scheduling practices in all of the agency’s health networks (Hicks, “Federal Eye,” Washington Times, 5/21).

The bill also includes provisions designed to address the backlog of veterans’ medical claims that has been worsened by VA’s inability to access medical data held by the Department of Defense.

According to The Hill, the measure is scheduled for a full committee vote on Thursday. An identical measure (HR 4486) has been passed by the House (The Hill, 5/20).

House Scheduled To Vote on VA Firing Bill

In related news, the House on Wednesday is expected to consider a measure (HR 4031) that would grant VA Secretary Eric Shinseki more authority to fire or demote senior executives, the AP/San Francisco Chronicle reports.

According to the AP/Chronicle, the measure — proposed by Rep. Jeff Miller (R-Fla.) — would target roughly 450 career employees who currently serve as hospital directors or executives in the agency’s 21 regions.

Separately, Shinseki and DOD Secretary Chuck Hagel met with the House Appropriations Committee on Tuesday to talk about how VA and DOD can improve communications between their separate EHR systems (Daly, AP/San Francisco Chronicle, 5/21).

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