CBS: Fifth VA office conducted wait-list fraud

posted at 11:31 am on May 10, 2014 by Ed Morrissey

The scandal at the Department of Veterans Affairs deepened late yesterday — and this time picked up a paper trail. CBS News obtained an e-mail from an official at a fifth VA office, this time in Wyoming, explaining how to game the wait-list system in order to stay off of “the bad boys list.” And it’s not the first time the VA has had an issue with the Cheyenne office, either:

The email, written by Telehealth Coordinator David Newman, a registered nurse, describes how patients at the Cheyenne VA Medical Center are always listed getting appointments within a 14-day window, no matter when the appointment was first requested, and no matter how long the patient actually waited.

The memo admitted, “Yes, this is gaming the system a bit…” because “when we exceed the 14 day measure, the front office gets very upset, which doesn’t help us.”

The employee further instructs staff on how to “get off the bad boys list” by “cancelling the visit (by clinic) and then rescheduling it with a desired date within that 14 day window.”

VA Secretary Eric Shinseki, already under fire for the scandal in Phoenix and three other locations, issued a statement demanding an immediate audit of the Cheyenne office and a suspension of the employee who wrote the memo. However, CBS also learned that the VA knew of “improper scheduling practices” in December of last year, when the Office of Special Counsel was informed of the situation. That was also based on a whistleblower, just as the scandal in Phoenix was exposed, although the specific allegations in the earlier Cheyenne inquiry were different than this particular kind of scheduling fraud.

That leaves a few questions, though. What kind of follow-up did the VA do in Cheyenne? Did the follow-up include coaching on how to manipulate data rather than improve service? What kind of follow-up did the VA do on its 14-day wait-list metric in other offices? Any metric imposed on an organization will produce attempts to mitigate the work necessary to achieve it, and clearly that’s what happened in five different locations, if not across the entire VA chain. Either the leadership at the VA didn’t care to follow up to make sure that offices weren’t manipulating data, or they actively encouraged them to do so. With the problem now demonstrated at five different offices in various regions of the country, there really is no third option.

At best, this is a massive leadership failure that allowed veterans to die without proper medical care, at least in Phoenix and probably elsewhere, too. The VA needs some housecleaning, and it should start at the top.


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What they need to do is found out which va facility hasn’t committed fraud.

gerrym51 on May 10, 2014 at 11:34 AM

This can’t happen on Obama’s watch, the media needs to find a way to circle the wagons.

Cindy Munford on May 10, 2014 at 11:37 AM

Housecleaning?

Absolutely . . . The VA has been hugely bad for the 30 years I’ve been familiar with it.

But this problem raises an interesting question. What do you do when you’re being forced to abide by rules that it is impossible to comply with? (Think Ham Sandwich Nation)

BLOC on May 10, 2014 at 11:39 AM

CBS: Fifth VA office conducted wait-list fraud

…”it’s from a rouge facility in Cincinnati”…”there is no concerted effort too…”….another fake scandal…
Wait!…no!….never mind!

KOOLAID2 on May 10, 2014 at 11:39 AM

Apparently we have found yet another government endeavor requiring multiple enemas.

John the Libertarian on May 10, 2014 at 11:40 AM

Are they watching porn 6 hours a day?

John the Libertarian on May 10, 2014 at 11:41 AM

…you don’t need death panels!

KOOLAID2 on May 10, 2014 at 11:42 AM

Is there a cabinet department in this Administration that hasn’t shown impeachment-quality failure?

(although I can think of a lot of people who will take a certain delight in this secretary twisting in the wind)

formwiz on May 10, 2014 at 11:42 AM

I just wonder what types of “appointments” were redirected for 14 days, who was the target (everyone, or certain individual types), and why?

Call me crazy, but if someone can pinpoint this, they might get a faster answer.

upinak on May 10, 2014 at 11:42 AM

the media needs to find a way to circle the wagons.

Cindy Munford on May 10, 2014 at 11:37 AM

They’ve circled the wagons – around this story – makes it more convenient to completely ignore the Benghazi special committee.

Flora Duh on May 10, 2014 at 11:47 AM

Start blaming the Republicans and the sequester in 3, 2, 1……

missouriyankee on May 10, 2014 at 11:51 AM

Obama: “I just read about this in the paper”

BobMbx on May 10, 2014 at 11:51 AM

Nobody listened when vets themselves were warning the country against Obamacare, pointing to the VA as a prime example of the efficacy of government-delivered health care. Dry run for the nation writ large.

“Death Panels”? Call them “Wait List Panels.”

de rigueur on May 10, 2014 at 11:52 AM

Works both ways. My ex-stepfather used to go in with a scratch on his arm and get Vicadin.

The whole system is jacked.

They pass out hardcore meds pretty easily.

Saw it firsthand.

wolly4321 on May 10, 2014 at 11:56 AM

“Some people live. Some people die.” ~ Kathleen Sebelius, June 2013

IF THIS ADMINISTRATION WOULD ALLOW A 10 YEAR OLD TO DIE, WHAT MAKES YOU THINK THEY’D GIVE A DAMN ABOUT VETERANS?

ThePainfulTruth on May 10, 2014 at 12:03 PM

Let’s not jump to conclusions based on a very few incidents. /libs

trs on May 10, 2014 at 12:05 PM

Flora Duh on May 10, 2014 at 11:47 AM

Well there is that but I think the Benghazi story is going to go quiet anyway, at least for a while. I think the Republicans are going to be quiet and methodical to cut down on the mandatory partisan garbage. It won’t cut it down but I think they will try.

Cindy Munford on May 10, 2014 at 12:06 PM

Well there is that but I think the Benghazi story is going to go quiet anyway, at least for a while. I think the Republicans are going to be quiet and methodical to cut down on the mandatory partisan garbage. It won’t cut it down but I think they will try.

Cindy Munford on May 10, 2014 at 12:06 PM

Well, the IRS scandal really is a witch hunt………….

VegasRick on May 10, 2014 at 12:10 PM

I have a question. Given that most seniors go into the Medicare system and a lot of people have work related insurance, isn’t this a relative small number of people being served to be this firetrucked up? It doesn’t seem to boded well for Obamacare and what happens to us as it evolves.

Cindy Munford on May 10, 2014 at 12:12 PM

“Forcing people to wait was standard operating procedure.”

Of course it was. Government always, always, ALWAYS controls costs with rotten service. If they cannot do it the particular way they’ve been doing it, they’ll do the same thing some other way. If they are completely boxed in, they’ll be ‘forced’ to raise revenue from taxpayers.

We know that is how it works. We have thousands of years of human history screaming it at us.

Government is, by its fundamental nature, evil. It is always about force. It is always about coercion. That is what it is.

It is a necessary evil. It should never be used to do anything that is not genuinely necessary for it to do.

fadetogray on May 10, 2014 at 12:13 PM

The VA represents the end game for ObamaCare…but we will save $2500 a year.

d1carter on May 10, 2014 at 12:16 PM

VegasRick on May 10, 2014 at 12:10 PM

Don’t get me started. This is driving me insane. Lois Lerner did the exact same thing to the Moral Majority when she worked at the FEC and now the prosecutors in Wisconsin are using the same model on conservative groups in that state. EVEN when they lose in court, and they will, they win. They have accomplished their goals of stealing confidential information, tying up the organizations and running off their donors. Someone needs to go to jail. Probably a lot of people need to go to jail. But it’s probably “legal”.

Cindy Munford on May 10, 2014 at 12:16 PM

There’s another situation at the VA hospital in Memphis that involves possible contamination of dialysis equipment. The Joint Commission has been called in to do an audit, and 8 of the 13 machines have been sent out for routine testing.

Hospitals who receive reimbursement from Medicare/Medicaid have to go through an certification process periodically in order to stay on the participating provider list via CMS. CMS allows The Joint Commission (TJC) to conduct these audits. If the hospital is approved via means of TJC audit, it is considered to have “deemed status” in the eyes of CMS. If it fails, it can be placed on probationary status or removed from the participating provider list altogether.

I’m not sure what “deemed status” policy is for VA hospitals. TJC acts a third party oversight provider and has been known to have a high level of credibility within the healthcare industry.

lineholder on May 10, 2014 at 12:17 PM

Squirrel for this pig.

They should go after him for this, and for so much more. He was busy kissing Hiallary/obama azzes, instead of looking after the Veterans, starting in AZ.

Sent him packing.

Schadenfreude on May 10, 2014 at 12:23 PM

Start blaming the Republicans and the sequester in 3, 2, 1……

missouriyankee on May 10, 2014 at 11:51 AM

You beat me too it. Sorry one hospital isolated incident but 5 is a top down effort by someone in DC. Remember DWS, MSNBC and many O-care supporters touted the VA when speking of government run healthcare. They had to show success. Now the media spin machine will be out in force as you say to blame this on the non-existent sequester cuts and mean Republicans.

hunthjof on May 10, 2014 at 12:27 PM

State Run Media: These are all local stories….

d1carter on May 10, 2014 at 12:30 PM

Time to shut down the VA. Just offer veterans vouchers for private care and let them choose their own doctors.

amalric on May 10, 2014 at 12:31 PM

“If these allegations are true, there a violation of law. It’s not a matter of resignations, it’s a matter whether somebody goes to jail or not,” said McCain, evoking thunderous applause from the crowd of more than 100 people.

Ah, John. Remember when you told us we had nothing to fear with Obama? Law doesn’t mean anything now. That old thing about justice for all? Not anymore.

butch on May 10, 2014 at 12:31 PM

I totally agree that what the VA appears to have done here ( probably WAY more than we know yet) is very, very bad.
However – I don’t understand the reaction from angry people. Half of America voted for the people that guaranteed us Obamacare.
And Obamacare is EXACTLY what the VA has already given us. RATIONED health care. Government obfuscation. Long waits. Poor care. No choices. Limited, and no choice of doctors or facilities. Fake caring. Lack of incentive in CARE but instead in RATIONING.
EVERYONE that supported Obamacare knew exactly what they would end up. VA care on steroids, for everyone but the politically protected , politicians, and very rich class.

builderD on May 10, 2014 at 12:36 PM

I can hardly wait for Obama to declare Obamacare ruined by the Republicans, then use his pen and phone to institute single payer government health care.

We are all gonna be in the “VA” now.

captnjoe on May 10, 2014 at 12:43 PM

“Some people live. Some people die.” ~ Kathleen Sebelius, June 2013
IF THIS ADMINISTRATION WOULD ALLOW A 10 YEAR OLD TO DIE, WHAT MAKES YOU THINK THEY’D GIVE A DAMN ABOUT VETERANS?

ThePainfulTruth on May 10, 2014 at 12:03 PM

If this administration will force babies still in the womb to die, who will they kill next? Obama’s whole administration is built around death – preferably to their enemies. Which is the prescribed end game for marxist/librul/progressives.

Old Country Boy on May 10, 2014 at 12:51 PM

I can hardly wait for Obama to declare Obamacare ruined by the Republicans, then use his pen and phone to institute single payer government health care.

We are all gonna be in the “VA” now.

captnjoe on May 10, 2014 at 12:43 PM

Was the plan all along.

CoffeeLover on May 10, 2014 at 12:54 PM

As I wrote in the Phoenix thread a few days ago: It’s institutional, it’s the way the healthcare machine is built (VA and BarkyCare). No one should be surprised as these cases are exposed.

The people at the top set the rules with an impossible logic that seems to come from “Underpants Gnomes” theory:

1. Reduce payments, reduce providers, and increase patient load.
2.
3. Great Health Care.

Administrators at each level of the heirarchy know their careers depend on making this plan appear to work. So they just pass if further down the chain. The guy left holding the bag at the bottom can either commit career suicide, or do whatever it takes to make the numbers seem to work. His superiors know this, but as long as they have deniability (“I’m shocked, shocked to learn of this!”), they’ll live with it.

bofh on May 10, 2014 at 1:14 PM

Time to issue everyone a beret and everything will be better!

GarandFan on May 10, 2014 at 1:16 PM

We have our own problems at the IRS, too. Kansas City is notorious for closing cases the moment they get them in order to boost their closure rates, hand-recording the case ID’s, and working them later. Problem is, quite a few never get worked… 99 times out of 100, if you filed an amended return and it was “lost”, it went to KC. And when they work them after the fact, they don’t capture any of their entries, so we have to guess at half of what they did. The reason they don’t capture is because the system would record a capture after a closure…

Boilerplate: All comments made by me are based on personal experience as an employee, and do not reflect any official position of the IRS or USA government, blah blah blah.

Asurea on May 10, 2014 at 1:18 PM

WOW the VA is a glowing example of why we need government run health care isn’t it?

bgibbs1000 on May 10, 2014 at 1:26 PM

Off Topic:

Holy crap I just saw the article from 5/4 cross linked about letting the IRS do your taxes… DO NOT DO THIS! There’s a lot of things we aren’t told by payers, and we will straight up screw you up. Not because we hate you, but because we don’t know you. On the most basic level, how do we know if you’re still married? Kids living with you? Etc… We have to assume the worst.

Asurea on May 10, 2014 at 1:27 PM

An email obtained by Fox News Friday revealed that an employee at a Wyoming VA hospital instructed his workers to manipulate records to make it seem like patients were being seen within the agency’s required 14-day window, which he described as “gaming the system.”

obama, the CiC…bonuses on the coffins of the Veterans.

Schadenfreude on May 10, 2014 at 2:18 PM

Socialists have no respect for individual life. They see humanity as a single homogenous entity. If we aren’t all the sam we have to be made the same.

crankyoldlady on May 10, 2014 at 2:18 PM

You have to mentally deranged to raise money of a dead person considering the circumstances.
I’m not even sure the devil will approve of this.

weedisgood on May 8, 2014 at 1:40 PM

Schadenfreude on May 10, 2014 at 2:20 PM

Famous military saying: “If you can’t take a joke, you shouldn’t have volunteered.”

Second famous military saying: “They’re right – nothing is too good for the troops.”

These have been around for a looong time.

PersonFromPorlock on May 10, 2014 at 2:34 PM

Let me see. A federal agency is unable or unwilling to comply with the rules it sets for itself. A systemic problem is revealed, many months later. A rogue employee or employees are blamed. Head of the Agency demands accountability, beginning with a probe into the allegations.

Aaaaannnnd, that’s where it ends.

Over and over and over again. Complete failure of leadership at the executive level which has manifested at the cabinet level. And still no one is ever held accountable.

BKeyser on May 10, 2014 at 3:09 PM

I’m beginning to sense a pattern here.

Another Drew on May 10, 2014 at 3:14 PM

Socialists have no respect for individual life. They see humanity as a single homogenous entity. If we aren’t all the same we have to be made the same.

crankyoldlady on May 10, 2014 at 2:18 PM

Yep; I’m pretty sure that Obamacare’s Death Panels would make the same decisions as these VA goons did.

slickwillie2001 on May 10, 2014 at 3:22 PM

upinak on May 10, 2014 at 11:42 AM

According to reports 40 vets died as a result of delayed access to appointments, which by law were mandated to be immediately scheduled in a 14-30 day window. The scandal broke relating to a sharp uptick in deaths from cancer that wasn’t detected or treated in a timely manner.

It looks, at least from preliminary reports, that those with complex needs, cancer, coronary care, etc. were delayed, certainly, as these are the vets who couldn’t wait for care or testing and died waiting.

thatsafactjack on May 10, 2014 at 3:29 PM

States should look to their Senators and Representatives in congress and demand answers.

Why was there no significant oversight of the VA?

How many letters from veterans have they received recently demanding an end to the delays and backlog in every aspect of the Veterans Affairs system?

Why have they largely ignored those letters from veterans and their families regarding the unforgivable, and illegal, delays in the VA system?

When we decided to clean house, hold people responsible for these deaths, and fire them for the willful neglect and mistreatment of our veterans and their families, let’s start at the very top of the chain of responsibility.

Let’s start with the staggering and shameful failure of our congressional public servants.

thatsafactjack on May 10, 2014 at 3:40 PM

Is 5 facilities greater than or less than a smidgeon?

can_con on May 10, 2014 at 3:55 PM

It is shameful that our Senators and Representatives in congress, duly elected and sworn to serve the interests of the constituents of the states that elected them, are more concerned with servicing the desires of their big cash donors and promoting amnesty for illegal aliens and demanding more visas for foreign labor to take American jobs, thus grooming their own career goals, than they are in seeing that the veterans of the state that elected them receive medical treatment they’ve earned by their blood and sacrifice in a timely and effective way.

They turn their back not only on the constituency of the state they’re sworn to represent, they also betray the men and woman of the Armed Forces and their families.

Throw the bums out and elect some real, dedicated, public servants.

thatsafactjack on May 10, 2014 at 4:07 PM

Sorry, but using the same scam to solve the same problem and qualify for the same bonuses in several different regions isn’t coincidence.

This HAD to come from Washington. There is no evidence Shinseki knew anything, but he is pretty much a dumb cluck anyway. But someone in DC was feeding the plan to the regions.

The Obamabots love to massage the numbers. Remember how they boosted their “deportation” numbers to all-time highs? They just started counting people turned back at the border as “deported,” which had not been done in the past. Suddenly, they look great without doing anything.

Before it is over with, we should have every single Obama appointee in a prison cell – or swinging from a rope (after fair and impartial trials, of course).

Adjoran on May 10, 2014 at 4:14 PM

“Forcing people to wait was standard operating procedure.”

Of course. They know a certain number will die and they won’t have to be bothered with more than providing a plot and one of those austere official VA headstones somewhere…much cheaper.

They did the same thing over Agent Orange and radiation exposure from nuclear tests/tactical maneuvers (and more radiation exposure now with sailors that assisted at Fukushima).

Meanwhile, the PTB are stealing billions a month from America.

Dr. ZhivBlago on May 10, 2014 at 4:38 PM

I’ve been wondering if the below is related to all this…

About 2 years ago, after we lost our home and moved to Cedar Rapids, I went to the VA about my Barrett’s Esophagus and some other problems. The doctor ( I could write a whole other post about her and her snide comment about the Catholic Church)referred me to the VA hospital in Iowa City for a Endoscopy and Colonoscopy. I supposedly had to go down and talk to a doctor who would determine if I needed them or not.

Well, every time my appointment came up, I got a call that it had to be delayed because the doctor wasn’t available. One time, my wife and I were driving down to the hospital when they called to cancel. Finally, after 10 months, I actually got down to the hospital and talked to one of the nurses. He decided I needed the procedures and scheduled me for the next month.

I never saw the doctor for this scheduling. The nurse did nothing but talk to me and look at my records before deciding I needed the procedures. For this, I took the time to travel down to Iowa City and back when I was working a graveyard shift. Most irritating since we could have done the same thin over the phone 9 months earlier.

The good news: the Barrett’s wasn’t any worse than it was, and the colonoscopy came back negative. I also got some excellent drugs and a pretty good sleep even if only for a short time, so it wasn’t total loss. But I never did figure out the 10 month delay, or the supposed need to see a doctor who I never saw.

I drive a truck now and I no longer need the VA. Thank God for that. It was an all together depressing place, anyway…

Kraken on May 10, 2014 at 5:10 PM

pork comes first

well no, re-election money comes first

then the pork

then the lawyer lobby,
then the wall street lobby
then the bankers lobby
then the real estate developer/home builder lobby
then the union lobby
then the ins. company lobby
then the highway construction lobby
then the home builders
then the mortage loan lobby
then the
then the
then the
then the

“”””

then the vets

APACHEWHOKNOWS on May 10, 2014 at 5:37 PM

APACHEWHOKNOWS on May 10, 2014 at 5:37 PM

Vets don’t rank that high.

As they used to say (paraphrase) about the FBI:
First in War,
Last in Peace,
Shut up and stop bitching.

Another Drew on May 10, 2014 at 5:46 PM

Need it be pointed out that the VA is a government-run health care system?

Apropos of nothing, of course…

jbspry on May 10, 2014 at 6:54 PM

Should be a lot of criminal charges coming, along with lawsuits.

Amazingoly on May 10, 2014 at 7:12 PM

This is inevitable when totalitarians take control and abuse power.

Brian in Titletown on May 10, 2014 at 7:53 PM

Any metric imposed on an organization will produce attempts to mitigate the work necessary to achieve it, and clearly that’s what happened in five different locations, if not across the entire VA chain.

Did the head honchos even consult with their office peons to find out if 14 days was a reasonable window for appointments?
Things which can’t be done, won’t be done.
Punishment for not doing them only ensures the system will be circumvented somehow.

This is analogous to the testing scandals where teachers changed answers to make it look like their students were doing better than they were, because their career and salaries were on the line.

All this gaming does is make it impossible to actually, you know, fix the problems.

Rewards for performance and innovation (ala the free market employment system) would produce much better results.

AesopFan on May 10, 2014 at 8:27 PM

Time to change incentives.
Instead of bonuses for doing their jobs we should start firing public employees for not doing their jobs. In order to see who is doing their jobs and who is not, each agency should be required to have competition from the private sector. If the employees are not at least 90% as efficient with their time as the private sector employees, give them the axe.

astonerii on May 10, 2014 at 8:35 PM

Ocare will lead to govt hospitals for everyone. Small one doc offices are going away, and we will be funneled down into the govt abyss of having to go to them for treatment. The VA scandal is a glimpse into our future. SP only scratched the surface with her description of death panels. I’ll bet the VA has a treatment advisory board that makes regulations for all the hospitals to follow including the bonus system because they know how greedy people think.

Kissmygrits on May 11, 2014 at 8:37 AM

Offer a large reward to find an honest Obama operation.

There may still be one somewhere!

Don’t look in Benghazi!
Don’t look in Obamacare
Don’t look in the CBC

Honesty sure is frowned upon by Obama and his crew

Obamatrix on May 11, 2014 at 9:16 AM

VA facilities must vary wildly in their level of care. DH uses the services of the Iowa City VA and there has never been one hint of this sort of thing with his appointments. I could write volumes about the caring staff there.

The Acting Director of the Iowa City VA is a lady named Sandra Horsman. Maybe they should promote her to Shinseki’s job.

As a side note, every VA facility has framed pictures of Barack Obama and Eric Shinseki on the lobby wall. You show see the looks those pictures get from the soldiers.

creeper on May 11, 2014 at 10:23 AM

I have to say that the VA hospital in White River Junction, VT exhibits NONE of the problems reported in the rest of the country. I have been a patient there since 2004. It is far from perfect, but seems like other VA facilities could learn something way up here in VT.
Regarding the pics on the lobby walls, I try my best to ignore them.
Lets hope Bernie Sanders puts some feet to the fire.

Lord Whorfin on May 11, 2014 at 4:21 PM

Government owes Vets
A higher level of care.
How will they treat you?

Who needs Death Panels
If you can’t see a doctor?
Time is the Panel.

Haiku Guy on May 11, 2014 at 8:45 PM

And Sarah Palin said there would be DEATH PANELS

treatment delayed is treatment denied

VA hospitals today obamacare tomorrow.

obama murdering VETS as vets vote conservative.

sniffles1999 on May 12, 2014 at 12:40 PM