VA watchdog finds local vets waiting months for VA Choice appointments

By Nick Ochsner, WBTV


The Inspector General for the Department of Veterans Affairs has found local veterans waiting months for appointments made through the VA Choice Program.

The watchdog announced the findings as part of an investigation into wait times at VA medical facilities and the VA choice program for a region including North Carolina and Virginia. The new report was released Thursday.

In the report, investigators looked at the total amount of time veterans were waiting for appointments at VA medical centers, community outpatient clinics and at private providers treating veterans through the VA Choice Program.

Congress passed a law in 2014 that required the VA to pay for veterans to be seen by a private specialist if they would have to wait more than 30 days to be seen by a VA doctor. That program became known as the VA Choice Program.

WBTV has been investigating problems and log wait times at VA facilities and the VA Choice Program for more than a year.

Our investigations have exposed veterans waiting months to even have an appointment scheduled through the VA Choice Program.

One veteran we talked with even experienced a worsening in his medical condition as a result of the extended wait time to be seen by a specialist through the VA Choice program.

The Inspector General's report reached a similar conclusion.

According to the report, 82 percent of veterans that received care through the VA Choice Program in VISN 6--the region that includes North Carolina and Virginia--in the time period studied waited more than 30 days.

"We estimated that overall, the approximately 22,500 veterans who received Choice care waited an average of 84 days to get their care through Health Net," the report said. "We estimated it took medical facility staff an average of 42 days to provide the authorization to Health Net to begin the Choice process and 42 days for Health Net to provide the service"

Despite Health Net's poor performance in ensuring local veterans get timely access to care in under 30 days, as the program intended, the company's CEO made more than $14 million in 2015, up from nearly $12.5 million the year before.

The IG's report singled out Health Net's poor performance and the VA's lax oversight as major reasons for veterans' delayed care.

"As discussed in Finding 2, many of the problems in obtaining timely access to care through Choice were caused by Health Net," the report said.

Investigators also found the VA did not have adequate resources to ensure the program was meeting its required targets. The report estimated that VA employees responsible for coordinating non-VA care (NVCC) has seen their workload increase 200 percent.

"NVCC staff at the seven VISN 6 medical facilities did not adequately monitor Health Net's information to ensure veterans received timely care and Health Net returned authorizations in compliance with the contract timeliness requirements," the report found.

The report also found that more than a third of veterans face wait times longer than 30 days at VA medical facilities in VISN 6, too.

"VISN 6 medical facilities did not consistently provide timely access to health care for new patient appointments," the report found.

Investigators estimated 36 percent of new patients waited more than 30 days for an appointment. Of that 36 percent, the report found the average wait time to be 59 days.

The report also notes that investigators found a significantly higher number of patients who had to wait longer than 30 days to be seen than what data in the VA's system showed for wait times. The VA's own data showed just ten percent of veterans had experienced extended wait times.

A separate investigation by the Inspector General released in October 2016 found employees at the Salisbury VAMC were instructed to manipulate wait time data in order to improve performance metrics.

In response to the report, the medical center's director said staff underwent more training and those supervisors had been removed from their roles.