Veterans' Benefits:

VA Needs to Verify Medical Expenses Claimed by Pension Beneficiaries

HRD-91-94: Published: Jul 29, 1991. Publicly Released: Aug 29, 1991.

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Pursuant to a congressional request, GAO determined the: (1) amount of unreimbursed medical expenses that beneficiaries report to the Department of Veterans Affairs (VA) for use in computing VA pension benefits; and (2) VA procedures for verifying such expenses.

GAO found that: (1) VA is unable to determine whether the claimed medical expenses are valid or not because it does not systematically verify or request proof of payment for these expenses, there is little incentive for voluntary compliance, and there is no deterrent to overreporting; (2) of the $1.6 billion in medical expenses that beneficiaries claimed, $1.25 billion were for recurring expenses and $350 million were for nonrecurring expenses; (3) of the recurring expenses, about $1.2 billion involved beneficiaries who were using their pensions to help pay for nursing home care; and (4) based on data that the Internal Revenue Service compiled, there is reasonable expectation that a substantial number of medical expenses claimed by pension beneficiaries could be overstated.

Recommendation for Executive Action

  1. Status: Closed - Implemented

    Comments: VA has issued new instructions for its regional office staff to use in verifying medical expenses reported by pension beneficiaries.

    Recommendation: The Secretary of Veterans Affairs should establish procedures for systematically verifying the accuracy of medical expenses claimed by pension beneficiaries.

    Agency Affected: Department of Veterans Affairs

 

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