A Veterans Affairs regional office in Wichita listed erroneous medical conditions for three dozen patients who were appealing rejected claims – an apparent effort to speed up the review process that might have had the opposite effect, government investigators found.
In a report released this week, the VA’s inspector general’s office said managers instructed staff at the Wichita facility to enter the same “placeholder” diagnostic code for a specific bone infection on 36 appeal claims. None of the 36 patients actually had the listed condition.
Investigators concluded the erroneous records likely stemmed from efforts in 2014 to resolve a backlog of mail at the facility, one of 56 regional offices across the nation. Because claims assistants weren’t able to accurately diagnose patient conditions, they entered the same incorrect code on all similar appeals, figuring they would be corrected later.
However, some of the claims weren’t fixed as they advanced through the appeals process, the report found.
The VA did not immediately return phone messages seeking comment. But the inspector general’s report noted managers at the Wichita office agreed with the findings and planned to implement recommendations to correct the 36 inaccurate records and install a better review process.
Concerned Veterans for America, a veterans’ advocacy group, said Wednesday that manipulation of data in VA facilities across the country is nothing new in the aftermath of the national scandal that erupted at a Phoenix veterans’ hospital two years ago over secret waiting lists and unnecessary deaths.
“Manipulation has kind of been a theme in the last couple of years as there has been a closer look taken at how the VA has conducted itself,” said John Cooper, spokesman for the group.
The agency’s investigation into the Wichita regional office began after it received an allegation of data manipulation in April 2015 in the Veterans Benefits Administration’s electronic records system used to track and manage its appeals workload. Investigators from the inspector general’s office arrived in Wichita in June 2015 for an unannounced review during which they interviewed staff and identified 36 pending appeals claims with the same medical diagnosis code.
It found all of those 36 claims had the same inaccurate diagnosis for the same bone infection known as osteomyelitis. Not only did none of those veterans actually have that medical condition, but the review also found 28 of those cases did not comply with policy for processing the claims and some contained multiple errors.