Audit of the Healthcare Enrollment Program at VA Medical Facilities

The VA Office of Inspector General (OIG) evaluated whether VA medical facilities processed veterans’ health care enrollment applications consistently with national enrollment standardization policies and goals. Accurate and timely enrollment is necessary for veterans to receive the health care they have earned.

The OIG team reviewed enrollment records created from October 1, 2022, through November 20, 2025, a period marked by an expected influx of applications following the passage of the PACT Act. The team also examined facility procedures through January 2026 to account for evolving eligibility criteria. The team found that while VHA has taken meaningful steps to standardize enrollment processes and strengthen oversight, gaps remain that could delay or prevent eligible veterans from accessing care.

Overall, staff correctly processed 75 percent of 420 sampled applications. However, the team noted areas of risk related to accuracy and program governance. Staff did not maintain or date-stamp 14 percent of applications, making it impossible to confirm whether they were processed properly or promptly. VHA staff also misinterpreted, overlooked, or inaccurately entered information resulting in incorrect eligibility or priority group determinations for 10 percent of the veterans’ applications reviewed. Furthermore, the team found practices at some facilities that prevented or delayed veterans’ applications from entering the enrollment system. 

These issues were due in part to oversight activities that did not fully evaluate the entire enrollment process at the facility level. Quality assurance efforts relied on completed applications, potentially missing cases that were never entered into the system.

The OIG issued eight recommendations to improve the enrollment program so that veterans’ applications are consistently processed in accordance with governing authorities. The acting under secretary for health concurred with all recommendations and provided action plans to address identified risks.