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GAO adds VA to list of programs at high risk of fraud, waste and abuse

Agency concerned about VA's $15 billion cash injection; Medicare, Medicaid remain on list

The Government Accountability Office (GAO) has updated its "High-Risk Series," adding the Department of Veterans Affairs (VA) health system to a growing list of federal programs that are vulnerable to fraud, waste and abuse.

The VA rounds out a list of 32 programs that the federal watchdog group categorized as vulnerable to fraud and abuse. The GAO notes that more than 100 recommendations have not been fully addressed within the VA system, as FierceHealthcare previously reported, and specifically calls attention to five risky areas:

  • Ambiguous policies and inconsistent processes
  • Inadequate oversight and accountability
  • Information technology challenges         
  • Inadequate training for VA staff
  • Unclear resource needs and allocation priorities

The VA has avoided the GAO high-risk list for years, but recent quality care concerns, including a backlog of medical appointments, have pushed the health system into the spotlight. In December, a report revealed that the VA wasted billions on construction projects while veterans died waiting to receive care--an indication of rampant mismanagement.

Last year, the government provided the agency $15 billion in emergency funding through the Veteran's Choice Act, which is one of the primary reasons the agency landed on the GAO's radar of high-risk programs. Between 2002 and 2013, the VA has added more than 2 million veterans to its system and increased its healthcare budget from $23 billion to $55.5 billion.

"The large funding amount is a reason it's on the high risk list," Debra Draper, director of healthcare issues for the GAO told the Wall Street Journal. "We just want to make sure the Choice Act is accomplishing what it's intended to do."

Medicare and Medicaid remained on the list, both of which are likely to require legislative changes in order to address fraud, waste, and abuse issues, according to the GAO. Recently, unnamed sources told Bloomberg that the U.S. made $125 billion in improper payments during the last fiscal year, up from $106 billion the previous year.

Although the news outlet did not identify specific areas of misspending, both Medicare and Medicaid have been identified as programs with high levels of questionable spending, FierceHealthPayer: AntiFraud previously reported.

For more:
- here's the GAO report
- read the Wall Street Journal article
- here's the Bloomberg article

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