After scandal, VA has yet to address 100 recommendations

Despite some improvements, the Department of Veterans Affairs (VA) has yet to fully address more than 100 of the Government Accountability Office's recommendations, according to a GAO report.

Earlier this week, the GAO put the VA on its biannual list of government programs, agencies and projects most susceptible to abuse, waste and fraud. The GAO commended the agency's efforts to improve but noted several concerns.

For example, the VA must clarify its existing policies to better standardize procedures at the local level, according to the report. Moreover, the agency must further strengthen accountability and oversight via more system-wide independent assessments of local procedures such as specialty care consultation resolution, the claims process for care outside the VA system and performance pay goals for VA providers.

Accountability remains a major issue for the VA, the report found, with the agency failing to make routine assessments of VA facilities' implementation of agency policies. In addition, the agency's oversight process does not always focus accurately on facility compliance, and the VA is overly reliant on self-reported data that is often incomplete or not validated by an independent party.

The VA should also collaborate with the Defense Department to correct problems solved by lack of interoperability, according to the GAO. Further, the agency recommends, the VA should take several steps to improve the VA staff training process, such as an emphasis on cleaning and disinfecting reusable medical equipment and aligning the VA's nurse staffing process with that of staff responsible for developing nurse staffing plans.

Congress, too, must continue to focus on oversight of the VA, according to the GAO. "Sustained congressional attention to these issues will help ensure that VA continues to make progress in improving the delivery of healthcare services to veterans," the report states. Despite VA Secretary Bob McDonald's reforms, as of last November 600,000 vets reported wait times of over a month, FierceHealthcare previously reported.

To learn more:
- here's the GAO report

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