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Recommendations

GAO recommends VBA (1) develop a plan for using its new data system to monitor contractors' quality and timeliness performance, (2) analyze overall program performance, (3) verify that contracted examiners complete required training, and (4) collect information to assess the effectiveness of that training. The Department of Veterans Affairs agreed with GAO's recommendations.

Recommendations for Executive Action

Agency Affected Recommendation Status
Department of Veterans Affairs 1. The Under Secretary for Benefits should develop and implement a plan for how VBA will use data from the new exam management system to oversee contractors, including how it will capture accurate data on the status of exams and use it to (1) assess contractor timeliness, (2) monitor time spent correcting inadequate and insufficient exams, and (3) verify proper exam invoicing. (Recommendation 1)
Open
VA concurred with this recommendation and outlined improvements in the information collected through VBA's new exam management system. VBA is testing a mechanism to validate exam invoices submitted by contractors. Additionally, in November 2020, VBA stated that it acquired a third-party Independent Validation and Verification (IV&V) contract to address discrepancies between VBA and contractor IT systems and that VBA seeks to monitor inadequate and insufficient exams on a real-time basis. VBA said that it views verification of proper examination invoicing as an on-going effort. As such, it continues to make improvements to the monthly invoice validation process prior to payment. VBA said it plans to fully implement our recommendation by September 31, 2021. It will be important for VBA to take the next step of developing and implementing a plan for how it will use information from the exam management system to ensure both accurate timeliness data and proper exam invoicing on an on-going basis.
Department of Veterans Affairs 2. The Under Secretary for Benefits should regularly monitor and assess aggregate performance data and trends over time to identify higher-level trends and program-wide challenges. (Recommendation 2)
Open
VA agreed with this recommendation. The agency stated that VBA will use improved data in the new exam management system to regularly monitor and assess aggregate performance data, identify error trends, and monitor contractor performance and program-wide challenges. According to VBA, as of November 2020, the agency continues to make progress improving its reports and anticipates implementing our recommendation by September 31, 2021.
Department of Veterans Affairs 3. The Under Secretary for Benefits should document and implement a plan and processes to verify that contracted examiners have completed required training. (Recommendation 3)
Open
VA agreed with this recommendation. The agency stated that VBA has started developing a training plan for contractors, as well as a new training delivery system, to validate that required training has been completed and to assess the effectiveness of this training through feedback from trainees, contractors, and quality review staff in VBA's contract exam program office. VBA intends to use this information to improve the implementation and content of training. VBA expects to fully implement its new training system by December 31, 2021. In the interim, VBA said that it will continue to conduct compliance audits of contractors to ensure they track completion of training by examiners. GAO will close this recommendation once VBA implements its new training delivery system that will allow it to determine whether all examiners have completed required training prior to conducting disability medical exams.
Department of Veterans Affairs 4. The Under Secretary for Benefits should collect information from contractors or examiners on training and use this information to assess training and make improvements as needed. (Recommendation 4)
Open
VA agreed with this recommendation. The agency stated that VBA has started developing a training plan for contractors, as well as a new training delivery system, to validate that required training has been completed and to assess the effectiveness of this training through feedback from trainees, contractors, and quality review staff in VBA's contract exam program office. VBA intends to use this information to improve the implementation and content of training. VBA expects to fully implement its new training system by December 31, 2021. In the interim, VBA has started to collect some feedback (e.g., through a survey) following training. GAO will close this recommendation once VA has implemented its new training delivery system, which will allow it to more systemically collect information on training to make improvements, if needed.

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