The research arm of Congress says more oversight of the Veterans Affairs Healthcare system is needed as it remains on a Congressional watchdog’s high-risk list for fraud after nearly a decade.
The U.S. Government Accountability Office released a report highlighting the need to address longstanding challenges in overseeing the expansive healthcare system and improve accountability, ensuring taxpayer dollars are used efficiently.
The Department of Veterans Affairs operates one of the largest healthcare systems in the nation, with 170 VA medical centers and more than 1,000 outpatient facilities and providing services to more than 9 million veterans with significant healthcare needs.
Two GAO priority recommendations are clearly defining roles and responsibilities in overseeing medical centers and improving operational efficiency in facilities with declining workloads.
The Offices of Integrity and Compliance, Internal Audit, and the Medical Inspector are responsible for oversight functions to identify, address, and deliver evaluations on how to better assist veterans’ health needs.
These functions include compliance, risk management, internal audit, and medical investigations.
GAO added VHA to the “high-risk” list in 2015 for potential fraud, waste, and mismanagement.
GOA’s report listed five areas of concern, including ambiguous policies and inconsistent processes, inadequate oversight and accountability, IT challenges, insufficient training for VA staff, and unclear resource needs and allocation priorities.
Inefficiencies potentially risk diverting funds from providing quality, timely care to the nation’s veterans.
In 2023, the VA operated with a discretionary budget of $134.7 billion.
Since 2015, VHA has changed various functions regarding the oversight offices to minimize fragmentation, overlap, and duplication. VHA stated in 2016 that their approach to oversight was the “root cause” of various inadequacies in the healthcare system
VHA reorganized offices again in 2024, eliminating the Office of Oversight, Risk, and Ethics and instead moving oversight offices under the Office of Integrity and Compliance.
VHA officials said these changes would “streamline VHA’s oversight by removing a reporting level between the Under Secretary for Health and the oversight offices responsible for managing the agency’s oversight functions.”
The Office of Internal Audit was opened in 2016 to provide insight into the inner workings of the healthcare system. However, its unclear reporting structure and oversight role created challenges due to VHA not defining the purpose of the internal audit function and a lack of updated policy directives.
VHA created the Audit, Risk, and Compliance Committee as the governance body to guide its oversight and make recommendations for system-wide improvements, but GOA found the committee failed to provide guidance and made no recommendations.
According to GAO, if the committee were to review oversight findings and provide recommendations, it could result in opportunities for system-wide improvement.
