Inconsistent Implementation of VHA Oncology Program Requirements Due to Insufficient Oversight

The VA Office of Inspector General (OIG) conducted a national review to examine the infrastructure and oversight of Veterans Health Administration (VHA) oncology programs.

The OIG found inconsistent implementation of VHA requirements for oncology programs. Not all Veterans Integrated Service Networks (VISNs) had an established multidisciplinary cancer committee, and none of the VISNs had submitted an inventory of oncology services or facility points of contact within the last year to the National Oncology Program Office.

Additionally, only 66 percent of facilities had an established cancer committee or had partnered with another facility or VISN to provide the required committee functions. Further, the OIG learned that a majority of VISNs did not fully comply with the requirement for complexity level 1 and 2 facilities to pursue membership in the National Cancer Institute, National Clinical Trials Network, or National Cancer Institute Community Oncology Research Program.

The OIG found a lack of oversight contributed to the inconsistent implementation of oncology program requirements. Insufficient oversight occurred with the National Specialty Care Program Office’s oversight of National Oncology Program implementation, National Oncology Program Office’s oversight of VISN and facility oncology program implementation, and VISN oversight of cancer care at VA medical facilities. 

The OIG made five recommendations to the Under Secretary for Health related to VISN‑ and facility-level multidisciplinary cancer committees; annual VISN submissions of an inventory of oncology services and facility points of contact to the National Oncology Program Office; facility pursuit of membership in the National Cancer Institute, National Clinical Trials Network or National Cancer Institute Community Oncology Research Program; and a review of oncology-related program offices to ensure the required oversight of VISN and facility oncology programs.