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Open Recommendations

Veterans' Community Care: VA Needs Improved Oversight of Behavioral Health Medical Records and Provider Training
GAO-25-106910
May 05, 2025
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5 Open Recommendations
Agency Affected Recommendation Status
Veterans Health Administration The VHA Under Secretary for Health should ensure that IVC develops guidance for VA medical centers' efforts in obtaining final medical documentation after all visits provided to a veteran under each referral have been completed. (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 VHA Under Secretary for Health should ensure that IVC establishes goals and related performance measures for VA medical centers in obtaining initial and final medical documentation from community 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 VHA Under Secretary for Health should ensure that IVC establishes a process for regularly using performance information for VA medical centers in obtaining initial and final medical documentation from community providers to assess its progress toward established goals. (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 VHA Under Secretary for Health should ensure that IVC establishes and monitors goals and related performance measures for community providers' completion of core trainings and ensures that community providers complete the required training course. (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 VHA Undersecretary for Health should direct IVC to take steps to ensure that it and its contractors communicate clear and accurate information to community providers regarding IVC's core trainings, including whether training is recommended or required. (Recommendation 5)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Benefits: More Thorough Planning Needed to Help Better Protect Veterans Assisted by Representatives
GAO-25-107211
Apr 28, 2025
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2 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of Veterans Affairs should ensure that its Office of General Counsel, in consultation with the Office of Information Technology, develops detailed plans that incorporate sound planning practices for its ADF program initiatives. These plans should detail necessary activities and timelines; identify resources needed; include risk assessments and, as necessary, applicable mitigation strategies; and identify a process to monitor and report on progress. (Recommendation 1)
Open
Following the issuance of GAO's report, VA stated that it concurred with this recommendation and was working to implement it. As of May 2025, VA reports that its Office of General Counsel is coordinating with the Office of Information Technology to develop plans. VA estimates its plans will be completed by the end of fiscal year 2025. We will assess VA's progress once these plans are available.
Department of Veterans Affairs The Secretary of Veterans Affairs should ensure that its Office of General Counsel uses the detailed plans it developed, in coordination with the Office of Information Technology, to implement and monitor the ADF program initiatives. (Recommendation 2)
Open
Following the issuance of this report, VA stated that it concurred with this recommendation and was working to implement it. As of May 2025, VA reports that its Office of General Counsel and Office of Information Technology will develop implementation plans informed by the level of resources available to the Department. VA estimates its implementation plans will be completed by the end of fiscal year 2026. We will assess VA's progress once these plans are available.

Electronic Health Records: VA Making Incremental Improvements in New System but Needs Updated Cost Estimate and Schedule
GAO-25-106874
Mar 12, 2025
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3 Open Recommendations
2 Priority
Agency Affected Recommendation Status
Department of Veterans Affairs
Priority Rec.
The Secretary of VA should direct the EHRM Integration Office to obtain an updated and independent total life cycle cost estimate using best practices described in GAO's Cost Estimating and Assessment Guide. (Recommendation 1)
Open
VA concurred in principle with the recommendation but its planned actions for updating an independent total life cycle cost estimate for EHRM do not address plans beyond the end of the current contract with Oracle Health. VA noted that it intended to employ best practices to develop a cost estimate for site deployments through May 2028, which is when the current contract with Oracle Health concludes. However, the department acknowledged that not all VA medical centers would have the modernized EHR system by the end of the contract; therefore, VA stated that the life cycle cost estimate would be dependent on a future acquisition. VA needs to obtain an updated and independent total life cycle cost estimate for its electronic health record modernization efforts, using best practices described in GAO's Cost Estimating and Assessment Guide. The cost estimate provides vital information needed for determining the magnitude of this modernization effort.
Department of Veterans Affairs
Priority Rec.
The Secretary of VA should direct the EHRM Integration Office to expeditiously and reliably update its integrated master schedule using best practices described in GAO's Schedule Assessment Guide. (Recommendation 2)
Open
VA concurred in principle with the recommendation but its planned actions for updating the integrated master schedule for the EHR modernization do no address plans beyond the end of the current contract with Oracle Health. VA noted that it intended to employ best practices to develop a schedule for site deployments through May 2028, which is when the current contract with Oracle Health concludes. However, the department acknowledged that not all VA medical centers would have the modernized EHR system by the end of the contract; therefore, the schedule would be dependent on a future acquisition. VA needs to obtain an updated integrated master schedule for its EHR modernization efforts using best practices described in GAO's Schedule Assessment Guide. The updated schedule is vital information needed for determining he length of this modernization effort.
Department of Veterans Affairs The Secretary of VA should direct the EHRM Integration Office and the VHA to identify baselines and performance targets for all nine identified metrics intended to measure program and system performance. (Recommendation 3)
Open
VA concurred with the recommendation to identify baselines and targets for all nine identified metrics to measure program and system performance. The department stated that the metrics and operational monitoring processes were implemented in August 2024. However, the baseline and target for one of the nine metrics has yet to be determined. The program planned to establish the baseline and target for all nine identified metrics after it had operationalized its process for addressing configuration change requests. We will continue to monitor the department's progress toward implementing this recommendation.

Veterans Health Care: Actions Needed to Improve the Foreign Medical Program
GAO-25-107149
Feb 19, 2025
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9 Open Recommendations
Agency Affected Recommendation Status
Veterans Health Administration The Under Secretary for Health should, in coordination with the Foreign Medical Program, develop and implement a modernization plan for the program's legacy claims processing system, including milestones, a description of the work necessary, and details on the disposition of the legacy system. (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, in coordination with the Foreign Medical Program, finalize the necessary steps to transition to electronic funds transfers and immediately prioritize their implementation in coordination with the Department of the Treasury, as appropriate. (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, in coordination with the Foreign Medical Program, evaluate and implement as appropriate strategies to help mitigate staffing challenges that affect the Foreign Medical Program. (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, in coordination with the Foreign Medical Program, designate a dedicated entity for managing the process of assessing fraud risks to the program, consistent with leading practices. This entity should have, among other things, clearly defined and documented responsibilities, and authority for managing fraud risk assessment for the program. (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, in coordination with the Foreign Medical Program, regularly identify inherent fraud risks in the program and coordinate with external stakeholders, such as the Department of the Treasury, as appropriate. (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, in coordination with the Foreign Medical Program, assess the likelihood and impact of inherent fraud risks in the program. (Recommendation 6)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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