Doctor: VA lapses led to poor care in S. Texas
Cost-cutting mandate said to have affected colonoscopies.
The burgeoning scandal over Department of Veterans Affairs patient care reached the Rio Grande Valley on Monday, where a former VA doctor accused the department of delaying colonoscopies for veterans with cancer and jeopardizing veterans’ visits to non-VA specialists because the agency took so long to re- imburse private providers.
The new allegations emerged as the chair of the Texas Senate’s veteran affairs committee on Monday called for an independent investigation into claims that patient wait-time data was manipulated at Department of Veterans Affairs clinics in Central Texas and San Antonio.
The claims of whistleblower Brian Turner, a VA scheduling clerk who said he saw data manipulation in Waco, Austin and San Antonio, were first reported by the American-Statesman last week.
Similar claims of fraudu- lent wait times and barriers to care have emerged in Arizona, Colorado, Wyoming and now the Texas border region.
Dr. Richard Krugman, the former associate chief of staff at the VA Health Care Center in Harlingen, told investigators that “patient care was
impacted by the VA’s requirements to cut costs,” according to a 2013 U.S. Office of Special Counsel report obtained by the American-Statesman.
Among Krugman’s accusations were that the officials depended on unreliable tests in place of colonoscopies because the “closest VA provid- er performing colonoscopies was four hours away by car
and the agency did not want to pay for fee-based services
closer to Harlingen.” In an interview with the Washington Examiner, which first reported the allegations, Krugman said that by the time many cancer-stricken veterans finally received colonoscopies, their cancer had become “basically inoperable.”
Krugman also told investigators that local specialists “were owed millions of dollars, thus making these phy-
VA continued on
sicians reluctant to perform additional services for veteran patients.”
VA investigators found that the facility was not paying local physicians in a timely manner, but denied most of Krugman’s claims about patient care.
In Austin, Sen. Leticia Van de Putte, D-San Antonio, demanded accountability from top VA leaders over claims that local scheduling clerks were trained to falsely input appointment data to make it appear that waiting times were much shorter than they really are. The VA aims to see patients within 14 days of their desired appointment dates, and medical centers are graded on their ability to hit those targets.
“It appears the motivation for the deception … was a personal payday in the form of a VA performance bonus,” said Van de Putte, who is running for lieutenant governor. “Someone is responsible. These scheduling clerks didn’t just decide to falsify reports all over the country at the same time. … The allegations show a pattern that crosses multiple clinics and shows the actions were condoned at a pretty high level.”
In San Antonio, whistleblower allegations have sparked a probe from the VA’s Office of Inspector General, and VA auditors are scheduled to visit Central Texas facilities this week as part of a nationwide audit of scheduling practices ordered by embattled VA secretary Eric Shinseki.
Central Texas VA officials substantiated one of Turner’s chief allegations on Friday, telling the American-Statesman that scheduling clerks were indeed directed not to use an electronic waiting list, which helps veterans waiting longer than 90 days for an appointment plug into vacancies created when existing appointments are canceled. But within the VA, some employees and officials have worried that the tool could be used against facilities as evidence of poor performance.
VA officials told the Statesman that the problem was a “training issue” that executive leaders weren’t aware of until they began asking questions after similar allegations surfaced at a Phoenix VA hospital last month.
While Austin-area VA officials have acknowledged many of the claims, their counterparts in San Antonio have denied Turner’s allegations and told San Antonio media outlets he recanted portions of his story when confronted by officials.
Turner on Monday angrily denied that he had changed his story.
“That is absolutely false information,” said Turner, who continues to work at San Antonio’s North Central Federal Clinic. “I’ve never recanted anything.” He said the clinic’s internal investigation of his claims consisted of one five-minute conversation. “They never asked to speak to me again,” he said.
Van de Putte also questioned whether local VA medical facilities have the resources they need to serve veterans adequately, citing what she said was the primary care doctors’ average caseload of 1,200 patients in Austin.
Lawmakers have put some of the blame for insufficient resources on the VA itself: in March, the department asked for a 3 percent increase in its medical budget, which struck some in Congress as too low, given the number of new veterans of Iraq and Afghanistan entering the system.
“Is that enough money?” asked Sen. Bernie Sanders, I-Vermont, at a March budget hearing. “It sounds to me like it’s not.”