Lawmakers seek answers in VA co-pay debacle (Minneapolis Star Tribune)
The Minneapolis Veterans Affairs’ faulty inpatient billing system has resulted in some Minnesota veterans having to pay thousands of dollars more in co-pays in the last five years. In a letter sent Thursday to the Secretary of Veterans Affairs Robert McDonald, all ten federal Minnesota lawmakers questioned how the potential for veterans to pay more in co-pays will affect them and what the VA plans to do to help. The letter pressed McDonald to address what authority the VA has to hold veterans accountable for these unbilled services and how many veterans will be billed. The letter also questions whether similar errors were made in outpatient billing and where the collected money will go. The lawmakers also inquired what services will be in place to help veterans through this process and whether there will be a grace period provided. In a rare instance for Capitol Hill, the letter was signed by all 10 of Minnesota’s congressional members and four of their neighbors from Wisconsin. “Our veterans sought care at the Veterans Affairs Medical Center in good faith and should not be suddenly saddled with thousands of dollars in bills years later due to the VA’s inability to properly track, record and bill for services,” the lawmakers wrote. “Each year, Congress appropriates billions to the VA for administering medical care and benefits earned by our veterans through their service to our nation.” The lawmakers urged the VA to investigate how the charges went unbilled initially and said the issues need to be corrected for the future.
Ailing veterans still at risk of theft from those appointed by the VA (Stars & Stripes)
Despite years of restructuring, a Department of Veterans Affairs financial management program still lacks enough oversight to prevent fiduciaries from stealing millions from vulnerable veterans, according to testimony Thursday in front of a Congressional committee. Through the program, the VA appoints and oversees fiduciaries to help veterans who are ill, injured or mentally incapacitated handle their benefits. A VA Inspector General report in 2010 found that fiduciaries had stolen nearly $15 million from veterans between 1998 and 2010, and a more recent review found persistent problems with the program and millions more stolen. The review found that the Veterans Benefits Administration failed to meet its own deadlines to conduct field examinations of fiduciaries in 42 percent of cases, putting more than $800 million in benefits and estate values at risk. Testimony from the VA Inspector General’s office also highlighted egregious examples of fraud. In one case, a Houston attorney who served as a guardian for 54 veterans conspired with his wife to steal more than $2 million from veterans’ bank accounts. Some of the cases detailed in written testimony from the VA Inspector General describe fiduciaries stealing from incapacitated relatives, including a New Hampshire woman who was incarcerated for a year after stealing hundreds of thousands of dollars from her father. “Without more effective controls, including more consistent and timely completion of some of the program’s most important functions, unacceptable risks to the general well-being and VA benefits of some of VA’s most vulnerable beneficiaries will remain,” Deputy Assistant VA Inspector General Gary Abe wrote in testimony submitted to the House Committee on Veterans Affairs Subcommittee on Disability Assistance and Memorial Affairs. A particular area of concern is widespread mismanagement found in the Eastern Fiduciary Hub in Indianapolis, which oversees the program in 14 states. An Inspector General’s audit found that officials failed to investigate nearly 90 percent of allegations of fiduciary misuse of funds within 14 days as required, and that it took an average of 162 days instead. Auditors also found more than 3,000 pieces of mail, some “time critical,” that had not been processed within five days as required. Instead, the processing of correspondence, including allegations of fiduciary malfeasance, took from 11 to 486 days.
VA, NIH database may help identify veterans at risk of suicide (The New York Times)
Researchers at the Department of Veterans Affairs and the National Institutes of Health have developed a database they say can identify veterans with a high likelihood of suicide, in much the same way consumer data is used to predict shopping habits. In a study published Thursday in The American Journal of Public Health, researchers reported that a computer algorithm using hundreds of variables among millions of V.A. patients was able to correctly predict small subgroups with suicide rates up to 80 times higher than V.A. patients as a whole. The study also found that current practices that rely on doctors and other medical staff to flag high-risk patients miss the vast majority of such veterans. “So much of suicide prevention is throwing things at a wall and hoping they will stick,” said Caitlin Thompson, the V.A.’s deputy director for suicide prevention and an author of the study. “We haven’t been able to target people, so having something like this is such a gift.” The suicide rate for veterans has been much higher than that of the civilian population for years, and it has risen sharply among young veterans since 2009. The V.A. estimates the suicide rate for male veterans younger than 29 is 80 per 100,000 — about four times the comparable civilian rate. Data shows the rate for female veterans, though much lower than the male rate, is six times the comparable civilian figure. Increased mental health staff and traditional suicide prevention efforts have so far failed to bring the rates down. Four years ago, the V.A. began building a database to try to pinpoint high-risk veterans using national electronic health records for the millions of individuals in the V.A. system. It was designed to search for patterns in existing records using 381 variables, including medications, diagnoses, age, sex and a history of suicide attempts. To ensure that the patterns the system found could be used to predict actual suicide risk, researchers created the algorithm using data from half of the patient population from 2008 to 2011, then tested it on the other half from the same period, said a lead researcher, Robert Bossarte, the director of epidemiology in the V.A.’s Office of Public Health. Predictions for the test population lined up with the actual suicide rates, he said.
GAO: VA isn’t following treatment guidelines, suicide data inaccurate (Fierce Government)
The Veterans Affairs Department isn’t following guidelines when treating depression and its suicide data is inaccurate, the Government Accountability Office told a House panel Wednesday. In 2013, VA estimated that about 1.5 million veterans required mental healthcare, including for major depressive disorder, GAO says in its June 10 testimony to the House Veterans Affairs subcommittee on oversight and investigations. VA policy says that antidepressant treatment must be consistent with VA’s current clinical practice guidelines for major depressive disorder, GAO said in testimony. But when the GAO reviewed 30 veterans’ medical records it found that wasn’t always the case. Although the VA recommends that veterans’ depressive symptoms be assessed at four to six weeks after initiation of antidepressant treatment using a standardized assessment tool, 26 of the 30 veterans were not assessed in this manner within this time frame. And GAO found that the VA has no system-wide process in place to assess the extent to which veterans with major depressive disorder who have been prescribed antidepressants are receiving care after the medication is prescribed. GAO also found the VA’s data on veteran suicide isn’t complete, accurate or consistent. The VA uses the Behavioral Health Autopsy Program to collect data to use to develop policy to help prevent future suicides, the report says. But GAO’s review of the 63 completed BHAP reports at five VA medical centers found that over half of the reports submitted to the VA had incomplete or inaccurate data.
Veteran’s family calls report exonerating VA a ‘whitewash’ (CNN)
The family of veteran Richard Miles, who killed himself after visiting a Veterans Affairs hospital in February, tells CNN that an Office of Inspector General report exonerating the VA of any poor judgments in his case a “whitewash.” “I would definitely use the term whitewash,” Katie Hopper, Miles’ friend and the mother of his daughter, said of the report. “I feel like it was given to a legal team to make sure it sounded legally correct.” Miles, 40, was a veteran of the war in Iraq who was hospitalized several times over the years after suicide attempts and diagnosed with Post Traumatic Stress. On Feb. 15, after disappearing from his job for several days, Miles entered a U.S. Department of Veterans Affairs hospital in Des Moines, Iowa, and told the staff: “I need help,” according to hospital records obtained by CNN. As CNN covered in March, Miles had told Hopper and another friend, Harry Aller, that he was going to check himself in at the VA. At the ER, he was diagnosed with “worsened PTSD,” anxiety and insomnia, but he was not admitted to the hospital. Five days later he was found dead in the woods, having died from exposure to the elements after having taken a toxic amount of sleeping pills, according to a toxicology report obtained by CNN. The inspector general report states: “We did not substantiate the allegation that the patient had been denied long term mental health services at the time of a winter 2015 Emergency Department visit. We found no documentation that the patient had requested these services or that his clinical condition would have warranted admission at the time of his presentation.” “I don’t feel like they really looked at the record of his last visit and the things that he said,” Hopper said.
Senate passes short-term bill to allow work to continue at Colorado VA hospital (The Denver Post)
With the future of Aurora’s Veterans Affairs hospital again in doubt, the U.S. Senate on Thursday passed another short-term funding bill that would keep work going on the site until at least October. The $150 million measure, which passed by unanimous consent, comes just days before the troubled Colorado project was set to shut down because of a lack of money. Now the bill heads to the House, which is expected to take up the measure by Saturday. “This gives us the breathing room we need to finish the job in Colorado,” said U.S. Sen. Cory Gardner, R-Colo., in a short floor speech. Taken alone, the $150 million does not represent an increase in federal spending; rather, it allows the VA to reroute money it has within its own 2015 budget. The cash would come from a variety of VA pots — from $3 million in minor construction at VA staff offices to $80.7 million in “green energy” projects. Thursday’s action is the latest chapter in a legislative drama that has consumed the Colorado delegation since March, when the U.S. Department of Veterans Affairs revealed the cost of the Aurora hospital had ballooned to $1.73 billion.
Congress rejects VA raid on Filipino veterans’ fund (Las Vegas Review-Journal)
Congress on Thursday rejected a plan by the Department of Veterans Affairs to redirect $35 million from a Filipino veterans fund to help bail out a troubled hospital project outside Denver, quickly prompting a revised plan. With the VA pressing for quick action to avoid a construction shutdown in Colorado, lawmakers put together an alternative that would provide the agency with what it needed. The new legislation passed the Senate and was expected to pass the House by the weekend. According to Lauren Gaydos, spokeswoman for the Senate Committee on Veterans Affairs, the new bill would shield the Filipino Veterans Equity Compensation Fund, established in 2009 for payments to soldiers, guerrillas and scouts who fought alongside Americans in World War II. The VA had proposed tapping the Filipino veterans fund as part of a $150 million short-term funding package for the hospital in Aurora, Colo., but ran into opposition. Sen. Mazie Hirono, D-Hawaii, said it was “not acceptable.” Lawmakers from Nevada, home to a substantial population of Filipinos, also protested. Besides protecting the fund at least for now, the late deal provides veterans advocates breathing room for a campaign to distribute more money from the fund. Close to 43,000 claims were filed by a September 2010 deadline, but only 18,929 were found eligible, according to the VA. About $56 million remains unspent.
Did frat brothers spit at veterans? Investigations conclude, no criminal charges (The Washington Post)
After spring break, the stories went viral: The head of a Florida group said fraternity brothers had spat at wounded veterans at a Panama City resort and urinated on American flags. It would have upset people whenever it broke, but following as it did other well-publicized ugly behavior by fraternity brothers elsewhere, the allegations were particularly incendiary. So much outrage followed that within days, more than 70 death threats had been reported to the University of Florida’s Zeta Beta Tau brothers. The university and national headquarters of the fraternity quickly moved to shut down the chapter. But as investigators looked into the incidents, it seemed, it wasn’t quite so clear-cut. Recent inquiries concluded without evidence that veterans had been targeted. The manager of the resort, Clair Pease, told lawyers under oath that she did not think any veterans were disrespected, and that she would have no reservation about allowing the group to stay there again. She told them some veterans complained after a bottle was popped open on a balcony and a cork and some champagne spilled over onto people below. The fraternity brothers involved apologized profusely, she said. Police in Panama City Beach closed an investigation last week without criminal charges. A statement from ZBT headquarters Thursday evening said that their investigation, along with those of the University of Florida and the Panama City Beach Police Department, “did not find any evidence that ZBT members engaged in the more egregious allegations, including spitting on veterans or urinating on the American flag. The investigations also indicate there was no malicious intent nor any attempt by members to target the veterans who were staying at the resort.”
Graveside services to be allowed again at Montana veterans cemeteries (The Missoulian)
Gov. Steve Bullock issued a directive Thursday that says graveside services at state veterans cemeteries will again be allowed upon request. The directive broadens the scope of a policy that said graveside services would only be granted in spiritual or other special circumstances. The policy also said families and loved ones generally could only visit the gravesite after a burial was complete. “When a Montana veteran is laid to rest, their loved ones should be near them throughout the ceremony, including the graveside burial,” Bullock said in a statement on the new directive. New shelters and columbariums were built about a year ago to use for services at veterans’ cemeteries in Missoula and Helena, replacing graveside services. Montana Veterans Affairs Division administrator Joe Foster said previously that replacing graveside services in this manner complied with National Cemetery Administration policy. He said the policy was put in place because of safety and liability concerns. Foster didn’t immediately return a call seeking comment on the altered policy.
Veteran wrongly accused of stolen valor cancels meeting with town mayor (PennLive.com)
A 75-year-old veteran falsely accused of “stolen valor” in Harrisburg backed out of a planned meeting with police officials Wednesday after public comments by Mayor Eric Papenfuse that the veteran said “justify what took place.” Robert D. Ford said he had agreed to meet with Police Chief Tom Carter, Capt. Deric Moody and Detective John O’Connor at 3 p.m. Wednesday. But Ford said he changed his mind after seeing news reports of Papenfuse’s comments that indicated Ford was at least partly at fault for the incident. “It is apparent to me that after two weeks, this so-called ‘meaningful apology,’ while possibly sincere by the persons actually involved, seems to be nothing more than an effort by the mayor to continue to justify what took place,” Ford said. Ford said he believed the mayor was trying to “place the blame on me for becoming upset during that horrifying incident.” Ford said the mayor “doesn’t have a clue as to what actually took place and in view of what everyone knows has been reported thus far, is in fact calling me a liar, as I have publicly provided my account for the record.” According to Ford, a police officer approached him at ArtsFest on Memorial Day and asked him questions about his military service after a 22-year-old Army soldier complained about Ford’s Marine uniform. Ford said he answered the officer’s questions and the officer left, but returned a second time with more pointed questions, Ford said. The witness interviewed by PennLive didn’t want her name published, but reiterated Wednesday night that the officer “was being really antagonistic. “I was really shocked at how the police officer was handling him,” she said. “It was very unprofessional.” Ford served in the Marines from 1958 to 1964, when he was honorably discharged.
VA picks team to devise plan to revitalize West LA campus (The Los Angeles Times)
The federal Department of Veterans Affairs has chosen a team to devise a master plan, due Oct. 16, for revitalizing the agency’s West Los Angeles campus to best serve veterans in need of housing, health care and other aid. “We will transform the West L.A. VA campus into a vibrant community,” Vincent Kane, senior advisor on homelessness to VA Secretary Robert A. McDonald, said in a statement Thursday. The master plan team will be composed of three firms that will work with residents, veterans service organizations, elected officials and nonprofit groups to tackle the job of determining how best to use and refurbish the 387-acre campus. The VA has long been criticized for inadequately maintaining the campus with its many historic buildings, even as more than 4,300 veterans, at last count, sleep on the streets of Los Angeles County. In January, the VA agreed to settle a lawsuit filed on behalf of chronically homeless veterans. The agency agreed to transform the sprawling campus into a center of permanent housing and to curtail the controversial practice of leasing VA facilities to corporations and other non-government entities. Local and federal officials have committed to ending veterans’ homelessness in the county by the end of the year. Last week, the West L.A. campus opened Building 209, a structure with supportive housing for chronically homeless veterans with medical and mental health needs.