Whistleblower expands VA wait-list fraud to eighth facility

Add yet another VA facility to the deadly wait-list fraud scandal. The Daily Beast heard from a whistleblower in the Albuquerque VA organization that the same kind of wait-list fraud alleged at seven other facilities occurs in New Mexico as well. Veterans have to wait months to get medical attention, and any investigation may already be too late for some of them:

Add Albuquerque, New Mexico’s to the growing list of VA hospitals accused of keeping secret waiting lists to hide delays for veterans seeking medical care. And it may already be too late to get to the truth and find out what harm, if any, was done to veterans there—VA officials are already destroying records to cover their tracks, a whistleblower inside the hospital tells The Daily Beast. …

“The ‘secret wait list’ for patient appointments is being either moved or was destroyed after what happened in Phoenix,” according to a doctor who works at the Albuquerque VA hospital and spoke exclusively with The Daily Beast. “Right now,” the doctor said, “there is an eight-month waiting list for patients to get ultrasounds of their hearts. Some patients have died before they got their studies. It is unknown why they died, some for cardiac reasons, some for other reasons.”

There’s no proof yet that veterans died while waiting for treatment, like what allegedly happened in Phoenix. But the doctor says it’s quite possible that some veterans would still be alive if they hadn’t been pushed through a record-keeping trap door that buried their requests for medical care.

On March 19, 2014, for example, a patient with a deteriorating heart condition requested to see a doctor. The patient was finally seen only days ago, on May 16, when they were admitted to the hospital for decompensated heart failure. “A near miss” as the VA doctor familiar with the case described it. “He could have died before being seen.”

That patient was fortunate. It remains to be seen whether all of the patients affected by the alleged wait-list fraud in Albuquerque were as fortunate. They certainly weren’t in Phoenix. Stars and Stripes notes that treatment delays have been listed as factors in more than 100 deaths, although over a time frame that begins in 2001:

As controversy swirls around the Veterans Administration over deaths caused by delayed care, an investigation by the Dayton Daily News found that the VA settled many cases that appear to be related to delays in treatment.

A database of paid claims by the VA since 2001 includes 167 in which the words “delay in treatment” is used in the description. The VA paid out a total of $36.4 million to settle those claims, either voluntarily or as part of a court action.

The VA has admitted that 23 people have died because of delayed care, and is facing accusations that hospital administrators are gaming the system to conceal wait times, including using a “secret list” at the VA in Phoenix. …

The Dayton VA in 2009 paid out $140,000 for a 2006 claim that was described as “Failure/Delay in Admission to Hospital or Institution; Medication Administered via Wrong Route; Failure to Order Appropriate Test.”

A pending $3.5 million claim from March 2013 was filed by a man who says delayed treatment of his wife’s cervical cancer resulted in her death in March 2012. The names of the veteran and her widower were redacted.

Issues with access and treatment delays have been around for decades at the VA. That’s the reason why VA Secretary Eric Shinseki imposed the 14-day wait list metric in 2009, when he took over the Department of Veteran Affairs. The move was supposed to correct the chronic problem of timely access for many veterans. Instead, VA facilities across the country appear to have engaged in widespread and suspiciously similar fraud, and no one at the VA from Shinseki on down seems to have bothered to do anything about it — and have lied about knowledge of the issue to boot.

That’s enough for Dana Milbank, who called this weekend for Shinseki to be canned:

Eric Shinseki has served his country honorably as a twice-wounded officer in Vietnam, as Army chief of staff and finally as President Obama’s secretary of veterans affairs.

But his maddeningly passive response to the scandal roiling his agency suggests that the best way Shinseki can serve now is to step aside.

Reports have documented the deaths of about 40 veterans in Phoenix who were waiting for VA appointments — the latest evidence of widespread bookkeeping tricks used at the agency to make it appear as though veterans were not waiting as long for care as they really were. The abuses have been documented over several years by whistleblowers and leaked memorandums, and confirmed by a host of government investigators.

That’s bad enough. Worse was Shinseki’s response when he finally appeared before a congressional committee Thursday to answer questions about the scandal. He refused to acknowledge any systemic problem and declined to commit to do much of anything, insisting on waiting for the results of yet another investigation.

Shinseki did not cover himself in glory in Senate testimony last week. One indication of how big the problem has become was the abrupt dismissal of Robert Petzel, who was already on his way out for retirement in September. However, his replacement turns out to be even more problematic:

The person nominated two weeks ago to replace the VA’s outgoing undersecretary for health was responsible for supervising one of the hospitals at the center of the current scandal.

Dr. Jeffrey Murawsky was nominated on May 1 to replace Dr. Robert Petzel as undersecretary of health at the Department of Veterans of Affairs.   Petzel’s “resignation” was officially announced today, although his impending retirement was first announced last September.

Murawsky is currently the network director–effectively the CEO–of the VA region that includes the Edward Hines, Jr. VA Hospital in Chicago.  Before he moved up the VA hierarchy, he worked as a manager at the hospital.

Hines Hospital was the seventh facility to face allegations of wait-list fraud. Murawsky seems better suited to be the target of the investigation rather than the man running it. It’s time to clean house entirely at the VA.

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