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Open Recommendations

Veterans Health Administration: Further Improvements Needed to Manage Fraud Risks in Beneficiary Travel Program
GAO-26-107596
Jun 29, 2026
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9 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Under Secretary for Health should develop guidance for BT Program staff on acceptable documentation for verifying residential addresses when claims do not meet BTSSS rules related to addresses or distance traveled. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health should communicate to staff responsible for processing invoices in IPPS the importance of adequately reviewing BT invoices to ensure they are not duplicates before certifying the invoices for payment. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health should regularly monitor and evaluate whether existing controls for preventing payment of potentially duplicate BT SMT claims and invoices between IPPS and eCAMS and within eCAMS are implemented as intended and are operating effectively to prevent payment of potentially duplicate SMT claims and, if necessary, revise controls. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health should regularly monitor and evaluate whether controls used to validate payment amounts that are manually overridden in BTSSS are implemented and operating as intended to prevent potential overpayments. (Recommendation 4)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health should regularly monitor and evaluate whether controls to prevent potential BT overpayments resulting from staff manually pricing claims in eCAMS, including controls that automatically set the paid amount to the billed amount, are implemented as intended and are operating effectively and, if necessary, revise controls. (Recommendation 5)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health should clearly define and document the responsible and necessary authority to lead fraud risk management activities in the BT Program. This could include revising the BT Program directive to clarify the BT Program's designee for leading fraud risk management activities and completing and implementing revisions to VHA-wide guidance to include a requirement for program offices to have a designee for fraud risk management activities. (Recommendation 6)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

VA Menopause Care: Actions Needed to Help Ensure Quality Care and Patient Education
GAO-26-107853
Jun 12, 2026
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2 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Undersecretary for Health should use the performance measures related to its clinical practice guideline for menopause to monitor implementation of the guideline recommendations across VHA medical facilities. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Undersecretary for Health should develop and implement a strategy to better ensure women approaching and experiencing menopause are provided educational information on menopause and VHA's menopause care. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Health Care: Training and Improved Oversight Needed for Reviewing and Reporting Providers with Clinical Care Concerns
GAO-26-107528
Jun 11, 2026
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7 Open Recommendations
Agency Affected Recommendation Status
Veterans Health Administration The Under Secretary for Health should develop training materials related to quality reviews, the NPDB adverse privileging process, and the SLB reporting process. As appropriate, these trainings should include reporting requirements; documentation requirements and preferred storage location; time frames; and provider scenarios. The trainings should be required for relevant VHA medical facility staff. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should initiate the SLB or NPDB reporting process for the seven providers we identified to determine if SLB or NPDB reporting is warranted for those providers. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should (1) assess the extent to which VHA medical facilities are meeting the suggested time frame in VHA policy when conducting external reviews, such as focused clinical care reviews; (2) assess the risk exceeding the suggested time frame poses to addressing clinical care concerns and to patient care; and (3) make changes to address identified risks as appropriate. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should (1) assess the extent to which VHA medical facilities are meeting the suggested time frame in VHA policy when conducting the SLB reporting process; (2) assess the risk exceeding the suggested time frame poses to reporting substantiated clinical care concerns and to patient care; and (3) make changes to address identified risks as appropriate. (Recommendation 4)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should review and clarify its policy requirements as to when to begin the SLB reporting process when a clinical care concern is identified. (Recommendation 5)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should ensure that the facility tracking tool for reviewing and reporting providers with clinical care concerns be updated to include confirmation that required quality review and reporting documentation is complete and saved in the appropriate location at the facilities. (Recommendation 6)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Affairs: Improved Oversight Could Strengthen Processes for Estimating Health Care Funding
GAO-26-107950
Jun 04, 2026
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5 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The VA Undersecretary for Health should establish formalized processes for communicating to its actuarial consultant during the annual model update process information on the data quality, including any limitations, of VA direct care data used in the actuarial modeling that informs VA's health care budget projection. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The VA Undersecretary for Health should identify an approach to help ensure that there is a formalized process for incorporating newly emerging data, when possible, in the model after initial model delivery and prior to submitting the health care budget projection for the President's budget request. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The VA Undersecretary for Health should identify an approach to help ensure that information on the extent to which the EHCPM estimates can vary are documented and reported, such as in the annual risk assessment report and take action to implement that approach. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The VA Undersecretary for Health should update its standard operating procedure for assessing its actuarial consultant's performance to include a formalized process for assessing the quality of the consultant's deliverables to ensure the consultant complies with the work laid out in the performance work statement. (Recommendation 4)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The VA Undersecretary for Health should ensure it has a formalized process, such as a Memorandum of Agreement, for meeting its goal for VA's Office of Actuarial Services to be involved in VHA's development of model estimates for health care. (Recommendation 5)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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