Bad data and poor system controls are compounding the backlog problems at the Department of Veterans Affairs, according to a new VA Office of Inspector General audit.
The audit substantiates allegations by whistleblowers that 867,000 records were marked as pending and that 47,000 veterans died while awaiting care.
The backlog of pending healthcare applications, veterans who died while their applications were pending, as well as purged or deleted veteran health records and unprocessed applications, have all contributed to VA’s data mismanagement.
Auditors specifically looked into allegations of mismanagement at the Veterans Health Administration’s Health Eligibility Center (HEC), the VA’s central authority for eligibility and enrollment processing activities. The HEC and four VA medical centers process healthcare applications using the Enrollment System (ES), which receives data from an older component of the Veterans Health Information System and Technology Architecture.
“Enrollment program data were generally unreliable for monitoring, reporting on the status of healthcare enrollments, and making decisions regarding overall processing timeliness,” reports OIG, which substantiated that ES had about 867,000 pending records as of September 30, 2014. “These ES records were coded as pending because they had not reached a final determination status.”
Auditors also confirmed that pending ES records included entries for individuals reported to be deceased. As of September 2014, more than 307,000 pending ES records, or about 35 percent of all pending records, were for individuals reported as deceased by the Social Security Administration.
“These conditions occurred because the enrollment program did not effectively define, collect, and manage enrollment data,” states the report. “In addition, VHA lacked adequate procedures to identify date of death information and implement necessary updates to the individual’s status. Unless VHA officials establish effective procedures to identify deceased individuals and accurately update their status, ES will continue to provide unreliable information on the status of applications for veterans seeking enrollment in the VA healthcare system.”
OIG also confirmed that VA employees incorrectly marked unprocessed applications as completed and possibly deleted 10,000 or more transactions from the Workload Reporting and Productivity (WRAP) tool over the past five years.
“WRAP was vulnerable because the Health Eligibility Center did not ensure that adequate business processes and security controls were in place, did not manage WRAP user permissions, and did not maintain audit trails to identify reviews and approvals of deleted transactions,” concluded auditors.
OIG provided recommendations to the Under Secretary for Health (USH) to address enrollment system data integrity issues, enrollment program policy limitations, and the access and security of the WRAP tool. The report also provided recommendations to the Assistant Secretary for Information and Technology (OI&T) to implement adequate security controls for the WRAP tool, and ensure the collection and retention of WRAP audit logs and system backups.
Further, OIG recommended that the USH and Assistant Secretary OI&T confer with the Office of Human Resources and the Office of General Counsel to fully evaluate the implications of the findings of the report, determine if administrative action should be taken against any VHA or OI&T senior officials involved, and ensure that appropriate action is taken.
The USH and Assistant Secretary OI&T concurred with OIG’s findings and recommendations.
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