Audit of Alleged Manipulation of Waiting Times in Veterans Integrated Service Network 3

The Chairman, Senate Committee on Veterans' Affairs, requested the VA Office of Inspector General review allegations that the leadership of the Veterans Integrated Service Network (VISN) 3 of the Veterans Health Administration (VHA) was manipulating procedures to misrepresent patient waiting times. We did not substantiate a willful manipulation of procedures with the intent to misrepresent waiting times by the prior VISN Director, who retired in February 2008, or by the Chief Medical Officer. However, we found that scheduling procedures were not followed, which affected the reliability of VISN 3 reported waiting times and caused the electronic waiting list (EWL) to be understated. Specifically, our results supported that 89 percent of new patients and 86 percent of established patients in VISN 3 were seen within 30 days of the desired appointment date compared to 95 percent and 99 percent, respectively, reported in the former VISN Director’s bonus justification. Also, we projected that approximately 1,900 veterans waited for appointments but were not included on the EWL, and an additional 10,500 veterans received appointments beyond the waiting time standards that were also not placed on the EWL as required by VHA policy. Complying with established procedures is critical to ensuring patients are seen in a timely manner and that VA has accurate and reliable information for its decision making purposes. We recommended that the Under Secretary for Health establish procedures to routinely test the accuracy of reported waiting times and the completeness of electronic waiting lists and take corrective action when testing shows questionable differences between the desired dates of care shown in medical records and those documented in the scheduling system.