Probe Finds VA Vulnerable to Fraud

Thursday - July 9, 2009  The Washington Post  Author: Steve Vogel  Original URL:  http://www.washingtonpost.com/wp-dyn/content/article/2009/07/08/AR2009070804055_pf.html

An investigation in the wake of a major fraud case involving the Department of Veterans Affairs regional office in Louisville has found that other VA offices around the country suffer security shortfalls that leave them vulnerable to the same type of alleged fraud. The review by the Department of Veterans Affairs Office of Inspector General found no similar allegations of fraud, but its report warns that gaps in VA's internal controls mean that "opportunities exist . . . to generate fraudulent large benefits payments."  A VA spokeswoman said yesterday that the department has taken actions to correct the problems. "VA has implemented safeguards to protect the integrity of benefit payments and actively monitors our payment processes for compliance," said Katie Roberts, press secretary for VA. "We remain committed to taking all actions necessary to eliminate the potential for fraud and ensure our veterans receive every benefit to which they are entitled."  In November, acting after an investigation based on a tip from a confidential source, the U.S. Attorney's Office for the Western District of Kentucky indicted 14 people in connection with a scheme to defraud VA by submitting altered or counterfeit medical records. The government accused Jeffrey Allan McGill, a former veteran service representative at the Louisville VA office, of working with co-conspirators, including 11 veterans, to submit fraudulent claims for military-related disabilities. McGill and co-defendant Daniel Ryan Parker, a former officer with the Disabled American Veterans service organization, are accused of falsifying documents to ensure that those claims were approved.  Five of the defendants have pleaded guilty to charges in connection with the case. The remaining defendants, including McGill and Parker, have pleaded not guilty and are set to go to trial in September, according to the U.S. Attorney's Office in Louisville.  Alarmed by the allegations, VA's inspector general office began an investigation in May 2008, six months before the indictments. Investigators visited three VA regional offices (VAROs) that had issued an abnormally high number of large retroactive payments to veterans, which adjust amounts paid earlier and are considered particularly susceptible to fraud. Investigators reviewed the files for 690 large retroactive payments made by the offices in Huntington, W.Va.; San Juan, Puerto Rico; and Los Angeles between 2005 and 2008 but found no fraud. "These results mean we can say with 90 percent confidence that this particular type of fraud is unlikely to be occurring at the VAROs selected for review during the sampled period," said the IG report, which was released June 30.  But the investigation found that the Veterans Benefits Administration, which oversees benefits and services for VA, failed to provide enough guidance to regional offices on how to maintain accountability over its official date stamps, which could be used to falsify documents. "The VAROs we visited, consequently, did not maintain adequate control over their date stamps, making them vulnerable to fraudulent schemes," the report says.
In Los Angeles, the review team found multiple date stamps left unsecured in the mailroom and the door taped to prevent it from locking. Supervisors in Huntington and San Juan were unaware of how many stamps had been issued or where they were located. In its response to the IG report, VA said it has already issued instructions to regional offices on how to keep track of the date stamps. VA adopted previous reforms after a scandal in 2001 in which employees at the Atlanta regional office generated about $11 million in fraudulent compensation claims. In response, VA began reviewing all retroactive payments of $25,000 or more. But that review was not designed to detect fraud based on altered documents, according to the IG report. The report recommends that VA examine medical records before making large retroactive payments. "We believe that VBA will continue to be vulnerable to fraud-related activities concerning large retroactive payments if controls over the retroactive payment and review process are not improved," the report says. Roberts said the department has adopted new procedures that will ensure that medical records are validated for authenticity.

New GI Bill will open private colleges to vets

Wednesday - July 8, 2009  The Salt Lake Tribune  Author: Brian Maffly  Original URL:  http://www.sltrib.com/portlet/article/html/fragments/print_article.jsp?articleId=12789172&siteId=297

A new GI Bill that takes effect next month offers a broad expansion of education benefits for military service members, opening new opportunities for veterans such as Park City's Cody Campbell. "It was totally surprising and amazing," said Campbell, 25, an inactive Marine sergeant who served in Iraq. "This is making Westminster [College] possible for me. Otherwise I would go to the University of Utah."

Nationwide, benefits will vary because the maximum is pegged to tuition at the most expensive public university in the veteran's state, which in Utah is $5,746 at the University of Utah. For veterans living in a low-tuition state who want to attend pricey private colleges, the benefit may be of limited value. But the disparity shouldn't hurt Utah veterans because the state has few private schools and those few are inexpensive, particularly Brigham Young University. So while veterans groups are crying foul in California, where there is no state tuition but private school tuition can exceed $38,000, Campbell and retired Army mechanic Jessica Snyder of Layton aren't complaining. This fall, both will enroll at Westminster, a small, private liberal arts school in Salt Lake City that has been recognized as a "veteran friendly" campus. Under the GI Bill's Yellow Ribbon program, the U.S. Department of Veterans Affairs covers much of private schools' tuition, while the schools cover the rest.  "I definitely would not be going to school. I would be working in a dealership as an apprentice or something," said Snyder, 24, whose husband is serving a third tour in Iraq. "Having a degree opens the door for me to do many things. You can't just get a job by saying you served in the military."  While Westminster has set aside 100 spots for veterans under the Yellow Ribbon program, only eight have been admitted so far. "The word is just getting out and veterans are just being released from duty. We'll end up in double figures [by fall]," said Lewis Levy, Westminster's admissions director. He expects all 100 spots will be filled in the next few years. "Utah is a prime place for this because the military has prominence here and we want to serve our local constituency," Levy said. "The veterans need to know that the opportunities are there and institutions like Westminster are opening their doors."  The U. also is participating in Yellow Ribbon for veterans who are admitted to expensive graduate programs. "We'll participate and help out veterans in those programs that they [Department of Veterans Affairs] don't fully cover," said Paul Brinkman, a U. executive in charge of planning and budget. "We'll see the effect on undergraduates right away. We already have hundreds of vets here." Campbell is completing an associate's degree at Salt Lake Community College and expects to study business management at Westminster, where he is excited about its intimate campus. "The private thing suits my liking," he said. "I like to interact with teachers. I can learn more when I can discuss things with them."  Snyder left the Army in 2007 after serving four years, but has had no higher education other the NASCAR Technical Institute. "I was a mechanic and I have outgrown that," she said. bmaffly@sltrib.com
The New GI Bill The Post-9/11 Veterans Educational Assistance Act covers costs associated with attending college for vets with at least three years of service and an honorable discharge. Benefits are limited to the highest tuition at a public school in the veteran's state, which in Utah is $5,746. But schools that participate in the bill's Yellow Ribbon matching-grant program can significantly expand the tuition benefit. Participating Westminster College, for example, has spots for up to 100 service members to earn degrees without paying anything toward the school's $25,000 tuition. Under Yellow Ribbon, the U.S. Department of Veterans Affairs covers half the difference between the tuition at Westminster and the University of Utah; Westminster covers the rest. The bill provides separate stipends for books and housing.

Bill Would Give VA's IT Programs $767.6 Million More

Wednesday - July 8, 2009 Federal Computer Week Author: Ben Bain  Original URL: http://fcw.com/articles/2009/07/08/web-va-budget.aspx

The Senate Appropriations Committee has approved a measure to fund the Veterans Affairs Department in fiscal 2010 that would provide more than $3.3 billion for the department’s Information Technology Systems programs, an increase of $767.6 million from the previous fiscal year. The bill, approved by the committee July 7, would offer hundreds of millions more than VA got for the programs this year. The increasemeets the levels requested by President Barack Obama and the spending approved by the House Appropriations Committee on June 23. The $3.3 billion would go to IT projects to develop electronic health care records, paperless claims systems, and the integration of medical and service records with the Defense Department, according to a summary of the bill provided by the office of Sen. Tim Johnson (D-S.D.). Johnson is chairman of the Appropriation Committee’s Military Construction, Veterans Affairs, and Related Agencies Subcommittee. According to a report explaining the legislation, the committee recommends spending $938.8 million of the IT money for staff salaries and expenses, about $1.57 billion on existing programs and would give about $800.5 million for new program development.  However, the bill would place restrictions on the spending of the money for new program development until the head of the department or the chief information officer certifies to Congress the amount that will be spent on programs. “While the committee remains very supportive of leveraging information technology solutions to transform the VA’s delivery of service to veterans, it nonetheless notes its extreme concern with the Department’s systemic problems surrounding information technology projects,” the report said.  However, the report said the committee was pleased with the VA leadership's efforts to improve IT management. In particular, the committee report highlighted the VA’s new Program Management Accountability System that is designed to eliminate long-term program failures.

We owe our veterans much more than this

Tuesday - July 7, 2009  The Philadelphia Inquirer  Author: Arlen Specter  Original URL:  http://www.philly.com/inquirer/opinion/20090707_We_owe_our_veterans_much_more_than_this.html

My proud veteran father, Harry Specter, fought and was wounded in the Argonne Forest in 1917. Years later, in an act of unparalleled political folly, the federal government refused to redeem in advance the war "bonuses" promised to veterans, even though the Great Depression had left thousands of them unemployed. My father felt helpless in his home in Wichita, Kan., as his former comrades in arms, who had survived enemy fire on the battlefront, were cut down by American troops while protesting on the main boulevard of the nation's capital. No veteran should ever have to await his "bonus." The nation owes its veterans a debt it can never repay. Foremost among its obligations to them is safe, reliable health care. The bungled radiation treatment of close to a hundred veterans with prostate cancer over a six-year period at Philadelphia's Veterans Affairs Medical Center falls far short of the government's promise to veterans. Ninety-two of the 116 veterans who received a kind of radiation treatment for prostate cancer there got inadequate or misdirected doses, which may have damaged adjacent tissues and organs, such as the bladder, peritoneum, and rectum. In many cases, the victims did not know they had received substandard treatment until months or even years later. If this had been a consumer product, we would be talking about a breakdown in quality control. That is essentially what happened here. All of the safeguards of quality care were missing. There was no peer review, no government or agency oversight, and not even a definition of what constituted a reportable "medical event" - which might have alerted authorities to the problems sooner. The bottom line is that problems with the procedure, known as permanent implant prostate brachytherapy, went undetected for more than six years. By the time they were detected, it was too late to undo the tissue damage sustained by the Rev. Ricardo Flippin, a 21-year Air Force veteran who served in Vietnam. Flippin suffered incontinence and radiation burns to his rectum. "I spent six months in bed, unable to walk or stand," he testified before a Senate Veterans' Affairs Committee hearing I chaired in Philadelphia last week. The House Veterans' Affairs Committee is to continue investigating questions surrounding the breakdown in Washington this week. In brachytherapy, small radioactive seeds are surgically implanted in the prostate to destroy cancerous cells. Of the 92 mishandled cases at the Philadelphia VA, 35 suffered unintended doses of radiation to an organ or tissue other than the prostate, and 57 suffered underdoses of radiation to the prostate, mainly because the seeds were implanted incorrectly or had migrated to other organs. The Department of Veterans Affairs, like other health systems, relies on a number of oversight systems to maintain the quality of health care in its medical centers. These include patient surveys; peer reviews; the VA radiation-safety program; the Nuclear Regulatory Commission, which monitors the use of nuclear materials; and the Joint Commission, a group tasked with accrediting the hospital. These systems all failed to detect the aberrant care at the Philadelphia VA. Flippin learned he had prostate cancer in September 2004, and he underwent brachytherapy in May 2005. It was not until July 2008 - more than three years later - that the Philadelphia VA finally informed him: "Our review of your treatment program has indicated that there is a possibility that you received a radiation dose to your prostate gland that was less than your physician intended." He was asked to report for a CT scan, after which he received a second letter stating: "The results of the CT scan indicate that the treatment you received did not meet the VA's high standard of care." No patient should have to endure what Flippin did. Timely peer review and oversight by responsible government agencies and the VA could have uncovered problems with the brachytherapy program, and corrective steps could have been taken to avoid later tissue and organ damage. If there was a saving grace in the grim recitation of Flippin's travails at last week's hearings, it was when his doctor, Gary D. Kao, a radiation oncologist from the University of Pennsylvania, said he wished he had done better, and the two men embraced. It was a gesture of reconciliation between patient and doctor that, however brief, concluded the hearing on a positive note.

More Female Veterans are Winding Up Homeless

Monday - July 6, 2009 The Boston Globe  Author: Bryan Bender Original URL: http://www.boston.com/news/nation/washington/articles/2009/07/06/more_female_veterans_are_winding_up_homeless?mode=PF

WASHINGTON - The number of female service members who have become homeless after leaving the military has jumped dramatically in recent years, according to new government estimates, presenting the Veterans Administration with a challenge as it struggles to accommodate the hundreds of thousands of returning veterans from Iraq and Afghanistan. As more women serve in combat zones, the share of female veterans who end up homeless, while still relatively small at an estimated 6,500, has nearly doubled over the last decade, according to the Department of Veterans Affairs. For younger veterans, it is even more pronounced: One out of every 10 homeless vets under the age of 45 is now a woman, the statistics show. And unlike their male counterparts, many have the added burden of being single parents. “Some of the first homeless vets that walked into our office were single moms,’’ said Paul Rieckhoff, executive director and founder of Iraq and Afghanistan Veterans of America. “When people think of homeless vets, they don’t think of a Hispanic mother and her kids. The new generation of veterans is made up of far more women.’’ Overall, female veterans are now between two and four times more likely to end up homeless than their civilian counterparts, according to the VA, most as a result of the same factors that contribute to homelessness among male veterans: mental trauma related to their military service and difficulty transitioning into the civilian economy.  But while veterans’ services have been successfully reaching out to male veterans through shelters and intervention programs, women are more likely to fall through the cracks.  “While the overall numbers [of homeless vets] have been going down, the number of women veterans who are homeless is going up,’’ Peter Dougherty, director of homeless veterans programs at the Department of Veterans Affairs, said in a telephone interview. The trend has alarmed top lawmakers and veterans groups, who fear that the federal government - which is already straining to care for new veterans suffering from post-traumatic stress disorder, brain injuries, and other physical ailments - is ill-prepared to deal with the special needs of female veterans who find themselves on the street.  Many of them are like Angela Peacock, a former Army sergeant who was diagnosed with PTSD when she returned from Iraq in 2004 and became addicted to pain-killers.  Later evicted from her apartment in Texas, she spent more than two years “couch-hopping’’ between friends and family before moving in as a squatter in an empty house in St. Louis. “They could kick me out anytime they want,’’ Peacock said in an interview. “I have been clean for two and a half years and am working on getting my life back, but it doesn’t happen overnight.’’  According to the National Coalition for Homeless Veterans, a nonpartisan advocacy group in Washington, about 23 percent of the homeless population in the United States are veterans. Nearly half are from the Vietnam era and three-fourths experience some type of alcohol, drug, or mental heath problem.  Most of the homeless vets, who are estimated by the Veteran’s Administration to number at least 130,000 on any given night nationwide, are men older than 50. With a new generation of veterans from Iraq and Afghanistan leaving the armed forces, however, the demographics are swiftly changing. And with more women serving on active duty - a full 15 percent of the military is now female - the share of female homeless veterans has grown from about 3 percent a decade ago to 5 percent, according to the VA. Among younger veterans, meanwhile, the share of women is nearly double, making up 9 percent of homeless veterans under the age of 45. “There are twice as many under 45 than above,’’ said Dougherty, who is also the executive director of the Interagency Council on Homelessness, which coordinates the federal government’s efforts to combat homelessness. In recent days, senior members of Congress have called for an expansion of some of the VA’s programs to ensure they are properly suited to meeting the needs of the growing female population. “Women veterans and veterans with children often have different needs and require specialized services,’’ Senator Patty Murray, a Democrat of Washington and a member of the Senate Veterans Affairs Committee, said in a statement.  Senator Jack Reed, Democrat of Rhode Island and a former Army officer, also believes more women-focused veterans services are needed. “We need to adapt services for our veterans to reflect this shift and provide more gender-specific resources, such as housing and counseling to prevent female veterans from becoming homeless,’’ Reed said.  For example, Rieckhoff, who served in Iraq before founding the Iraq and Afghanistan veterans group, said female veterans often face unique homelessness risk factors, including sexual assault while in the military and diminished earning potential in civilian life. But he also believes that the culture of the VA is mostly geared toward meeting the needs of men. “They are having a tough time evolving to meet the demands of women, who are at a higher risk for homelessness to begin with,’’ Rieckhoff said. The Obama administration has taken some steps toward combating homelessness among all veterans, including allocating $75 million to public housing authorities in the 50 states, Puerto Rico, and Guam to provide permanent housing and dedicated case managers for an estimated 10,000 veterans.  “For a woman veteran in particular, this is a way for them to have a place to live and not have to ditch the child while they take care of other needs that they have,’’ said Dougherty.  But Murray, Reed, and others say far more needs to be done, especially for homeless veterans with children. They have sponsored legislation that calls for $50 million in extra funding over the next five years to allow the Veterans Affairs and Labor departments to make special grants to homeless veterans with children, including for transitional housing.  The legislation would also allow the Labor Department to fund facilities that provide job training and child care for female veterans. Bryan Bender can be reached at bender@globe.com.

Bill Seeks to End Delays in Veterans’ Care

Wednesday - June 24, 2009 The New York Times Author: JAMES DAO  Original URL: http://www.nytimes.com/2009/06/24/us/politics/24vets.html?_r=1&ref=us&pagewanted=print

The House approved legislation on Tuesday that is intended to prevent delays in federal financing for veterans’ health care programs, a problem that has disrupted services provided by the Department of Veterans Affairs for decades, officials say. The bill, which has been a major lobbying priority of veterans’ organizations in Washington, would allow Congress to appropriate funds for health care programs one year in advance. Officials say that for 19 of the last 22 years, the department’s budget has been approved late, usually because of fiscal wrangling on Capitol Hill. As a result, veterans’ groups and officials say, the directors of veterans’ health care centers and clinics have often been unable to proceed on time with new services, staff expansions or renovations.  “Our veterans pay the price with fewer doctors, longer waiting times and more restricted access for the six million veterans using V.A. health care,” said Representative Bob Filner, Democrat of California and chairman of the House Committee on Veterans’ Affairs. Under current rules, if a new budget is not in place by the start of the federal fiscal year on Oct. 1, the Department of Veterans Affairs is required to operate on its previous year’s budget. Often, those budgets have lacked money to pay for even existing programs because of inflation, contractual increases and growing caseloads. Programs have often been postponed or canceled while hospitals and clinics await their new budgets, officials said. “If there were scheduled pay raises, we wouldn’t have sufficient funds to maintain the status quo, because the pay raise would have to be paid,” said Bob Perreault, a former director of veterans’ health centers in Atlanta, Philadelphia and Charleston, S.C. “That means we would not buy equipment and not do maintenance projects.”  Veterans’ groups say the problem has become more troubling as caseloads have grown with veterans returning from the wars in Iraq and Afghanistan. “When you have a flat-line budget, you can’t treat the new people coming into the system, which leads to rationing,” said Peter Dickinson, a consultant to Disabled American Veterans, an advocacy group.  A similar bill sponsored by Senator Daniel K. Akaka, Democrat of Hawaii and the chairman of the Committee on Veterans’ Affairs, has bipartisan support and is expected to pass the full Senate.  President Obama has endorsed the idea of advance appropriations for veterans’ health care. In testimony before the House veterans committee in March, Veterans Affairs Secretary Eric Shinseki said: “The care our veterans receive should never be hindered by budget delays. I share the president’s concern as well as his support for advance appropriations as a way to provide uninterrupted care.”  In addition, the House Appropriations Committee approved a bill that appropriates $48.2 billion for veterans’ medical care in the 2011 fiscal year.