The agency charged with caring for America's veterans has been backsliding in performance after making improvements from a scandal a decade ago, as patient wait times grow and numerous of its employees are caught swindling taxpayers or fudging statistics.
The sheer breadth of problems inside the Veterans Affairs Department were laid bare this month in a lengthy semiannual report by its inspector general that identified nearly $4 billion in losses and problems in just six months.
The issues ranged from a failure by the VA to recover more than $200 million in reimbursements from private medical providers to audacious criminal plots by employees and contractors ranging from stealing furnishings donated to homeless veterans to massive kickbacks. Investigations resulted in 104 arrests and more than 500 administrative actions in the first half of 2022.
Just before Memorial Day, for instance, Alisa Catoggio of Boca Raton, Fla., a former pharmacy technician and high-level executive assistant, pled guilty to taking part in a multimillion-dollar kickback scheme that went on for years undetected.
Catoggio admitted she participated in a scheme that paid approximately $40 million in kickbacks to patient recruiters in exchange for their referring prescriptions issued to a compounding pharmacy in Florida.
While inspections of individual medical centers showed some improvements in patient care, the inspector general still uncovered examples of egregious and deadly care of patients.
The VA hospital in Augusta, Ga., for instance, failed to detect the declining condition of a veteran after surgery, including malnutrition and alcohol withdrawal, before he died recently
"Prior to the patient's surgery, primary care staff failed to provide sufficient care coordination and treatment," the report said. "A provider failed to address the patient's abnormal chest images and poor nutrition, and failed to communicate test results to the patient as required.
"A primary care nurse failed to respond to the patient's secure message request for assistance two days before surgery. Additionally, a barium swallow test was not scheduled. The surgical team completed a preoperative assessment but failed to detect the patient's overall poor health. During the patient's hospital stay after surgery, medical-surgical nurses did not consistently assess alcohol withdrawal symptoms or administer medications as required."
Members of Congress also are increasingly worried that patient wait times — the issue at the heart of the Obama-era scandal that started in Phoenix in 2014— are creeping back up, particularly for new patients.
A website created by the VA to monitor patient service shows new patient wait times of 48 days at the Atlanta VA clinic, 88 days, at the Covington, Ga., facility, 25 to 50 days in the Phoenix area, 47 days at Scottsdale, Ariz., 66 days in Victorville, Calif., and 70 days in Valley Stream, N.Y.
To make matters even worse, some VA facilities are fudging wait times by failing to use the required calculations, an inspector general report revealed last month.
The Veterans Health Administration "has sometimes presented wait times with different methodologies, using inconsistent start dates that affect the overall calculations without clearly and accurately presenting that information to the public," the IG reported.
VA Secretary Denis McDonough has acknowledged the problems with honestly calculating wait times and lowering them for the benefit of veterans.
"We have to do a better job with that," he told Congress late last month. "We're working really hard on it because I am frustrated with it myself."
Peter O'Rourke, a former acting VA secretary under President Trump, said the slippage in wait times has "been a really sad thing to watch," after years of progress.
He said bureaucrats feel more emboldened under President Biden to revert back to old ways after years of pressure to innovate and meet performance standards.
"We're just seeing over and over again decisions being made, programs being reversed and really just the same kind of disappointing trajectory," he told the John Solomon Reports podcast.
The repeated failures inside the VA institutions have some candidates in the fall election running on plans to further privatize veterans' health care, allowing patients to skip clunky federal bureaucracies when they want.
"The VA is just really a disaster of a bureaucracy," said Joe Kent, a retired Green Beret deployed 12 times to war zones who is now running for a House seat in Washington state.
"I think that the VA is almost beyond repair," he added. "We need to put choice in veterans' hands. We have a massive country — it's impossible for veterans to get the services and the help they need at just a few centralized, [VA-run] hospitals.
"We need to actually have veterans go get the healthcare they need on the economy, whatever is closest and the most convenient for them."
The agency also struggles with accounting. The inspector general found the VA did not recover more than $217 million in costs that were recoverable from private health providers who treated veterans for non-military related ailments, a massive sum that could have gone to additional care.
The VA "did not establish an effective process to ensure staff billed veterans' private health insurers as required," the watchdog reported. "An estimated 54 percent of billable community care claims paid between April 20, 2017, and October 31, 2020, were not submitted before filing deadlines expired."
But of all the issues flagged by the department's internal watchdog, none has ignited more anger than VA employees engaged in fraud and wrongdoing.
Just last week a former VA employee in Phoenix was sentenced for stealing property, mostly home furnishings, that had been donated by Walmart to the VA for use by homeless and destitute veterans.
Other convictions in the last few months include:
- A former VA travel clerk pled guilty to a scheme that embezzled more than $487,000 in VA travel reimbursement funds, which he helped administer as part of his official duties.
- The VA pharmacy chief at the Erie, Pa., medical center was sentenced to two years of probation for unlawfully obtained multiple dosage units of hydrocodone and oxycodone from 2017 to 2020 from pill bottles awaiting delivery to VA patients.
- The former chief of cardiology at the Palo Alto, Calif., VA hospital pled guilty to sexual battery for repeatedly subjecting a subordinate to unwanted and unwelcome sexual contact, forcing the victim to resign her job.
- A total of 17 doctors and two healthcare executives involved in a kickback scheme for VA patients have agreed on settlements and paying $2.7 million in penalties.
