Audit of the Beneficiary Travel Program, Special Mode of Transportation, Eligibility and Payment Controls

Report Information

Issue Date
Report Number
15-00022-139
VA Office
Veterans Health Administration (VHA)
Report Author
Office of Audits and Evaluations
Report Type
Audit
Recommendations
6
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
The purpose of the Beneficiary Travel Program is to help alleviate the costs of travel to medical appointments for eligible veterans. Under this program, VA has the authority to pay travel expenses including mileage traveled by an eligible veteran to and from a VA-approved facility for the purpose of examination, treatment, or care. The Veterans Health Administration (VHA) also uses vendors to transport eligible beneficiaries with disabilities using vehicles approved for special mode of transportation (SMT) travel. SMT-approved vehicles include ambulances, air ambulances, wheelchair vans, or other modes of transportation that are specifically designed to transport disabled individuals. The OIG found VA Medical Centers (VAMCs) authorized SMT services for some ineligible beneficiaries, and VAMCs did not adequately validate some SMT vendor invoices prior to authorizing payment. VHA also missed an opportunity to reduce program expenditures on ambulance services by paying more than rates authorized by law for SMT services. VAMCs also allowed some beneficiaries that used SMT services to improperly receive mileage reimbursements for the same appointments. The OIG estimated VAMCs improperly authorized SMT services for 11,900 ineligible beneficiaries and VHA made 59,900 improper payments nationwide valued at $23 million to SMT vendors from October 1, 2014, through December 31, 2015. The OIG also estimated VHA could have saved $11 million from October 1, 2012, through December 31, 2015, by paying Centers for Medicare and Medicaid Services rates for ambulance services. In addition, the OIG estimated VHA made approximately $229,000 in improper payments to beneficiaries for mileage reimbursements when SMT services were also used from October 1, 2014, through December 31, 2015. If oversight controls are not strengthened, improper payments for SMT services may cost taxpayers approximately $173.8 million through December 31, 2020.

Open Recommendation Image, SquareOpenClosed and Implemented Recommendation Image, CheckmarkClosed-ImplementedNot Implemented Recommendation Image, X character'Closed-Not Implemented
No. 1
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The OIG recommended the Under Secretary for Health require Veterans Integrated Service Networks to implement periodic reviews to ensure clinicians and Beneficiary Travel Office staff comply with Veterans Health Procedure Guide 1601B.05 eligibility requirements for authorizing Special Mode of Transportation services.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The OIG recommended the Under Secretary for Health modify Veterans Health Administration Procedure Guide 1601B.05 to require the Beneficiary Travel Office staff to verify beneficiaries attended medical appointments prior to approving payment of Special Mode of Transportation vendor invoices.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The OIG recommended the Under Secretary for Health require Veterans Integrated Service Networks to implement periodic reviews to ensure VA Medical Centers comply with Veterans Health Administration policies for verifying beneficiaries listed on vendor invoices had been properly authorized for Special Mode of Transportation services or attended medical appointments prior to approving payment of Special Mode of Transportation vendor invoices.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The OIG recommended the Under Secretary for Health ensure the Improper Payments Elimination and Recovery Act reports provided to Veterans Integrated Service Networks are modified to include Special Mode of Transportation information specific to vendor payments by VA Medical Centers.
No. 5
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The OIG recommended the Under Secretary for Health implement use of Centers for Medicare and Medicaid Services Rates when savings can be achieved for Special Mode of Transportation ambulance services in accordance with 38 U.S.C. Section 111(b)(3)(C).
No. 6
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The OIG recommended the Under Secretary for Health implement controls to prevent beneficiaries using Special Mode of Transportation services from also obtaining mileage reimbursement for the same appointment(s).
Total Monetary Impact of All Recommendations
Open: $ 0.00
Closed: $ 173,829,000.00