Audit of VHA's Alleged Inappropriate Scheduling of Electromyography Consults at the Memphis VA Medical Center

At the request of former Chairman of the House of Representatives Committee on Veterans’ Affairs, we reviewed an allegation of inappropriate scheduling for 143 VA Electromyography (EMG) consults at the Memphis VA Medical Center (VAMC). Additionally, the Office of Special Counsel provided similar allegations stating the intent was to disguise wait times. We substantiated that Memphis VAMC staff did not follow appropriate procedures when they discontinued the 143 EMG consults. We did not substantiate that EMG staff discontinued these consults to disguise wait times. The Assistant Chief of the Business Office made the decision to discontinue these consults and authorize Veterans Choice Program (Choice) consults. This circumvented established procedures where EMG staff should have first scheduled the veteran and placed them on the Veterans Choice List if the wait time was greater than 30 days out. This circumvention of procedures occurred because the Assistant Chief thought bypassing the required scheduling process would save time and effort, and veterans would receive more timely care through Choice. The result was that patients who did not desire Choice care risked not being scheduled. The VAMC ultimately created a new VA consults for 21 veterans who opted not to use Choice. In reviewing the allegations, we determined that Memphis VAMC did not provide care within 30 days to veterans for six consults still waiting for care. The delays resulted from insufficient staffing resources in the EMG Clinic and Business Office. On average, the veterans who received their EMG appointment waited an average of 198 days to receive care. OIG made four recommendations. The Director of the Memphis VAMC concurred with all four recommendations. VHA’s planned corrective actions are acceptable. Based on the corrective actions completed, we considered Recommendations 1 and 4 closed, and we will monitor VHA’s progress until all proposed actions are completed.