VA Needs Better Internal Communication and Data Sharing to Strengthen the Administration of Spina Bifida Benefits

Report Information

Issue Date
Report Number
20-00295-61
VA Office
Veterans Health Administration (VHA)
Veterans Benefits Administration (VBA)
Report Author
Office of Audits and Evaluations
Report Type
Review
Major Management Challenges
Benefits for Veterans
Recommendations
4
Questioned Costs
$0
Better Use of Funds
$0
Congressionally Mandated
No

Summary

Summary
The VA Office of Inspector General (OIG) reviewed key aspects of VA’s spina bifida program in response to congressional and other concerns that eligible individuals may not be receiving the compensation, healthcare, home services, and other benefits to which they are entitled. Monthly payments under this relatively small but critical program (serving more than 1,000 beneficiaries) exceeded $20.8 million in 2019, with medical reimbursements of over $45 million. Spina bifida occurs when a fetus’s spine and spinal cord do not form properly. Children born with spina bifida may receive VA benefits such as monthly payments, home services, and health care if one of their biological parents is a veteran presumed to have been exposed to herbicides during the Vietnam War. The Veterans Benefits Administration (VBA) determines eligibility for spina bifida benefits and issues monthly payments. The Veterans Health Administration (VHA) covers all medically necessary health care. The OIG found VBA staff generally decided spina bifida benefit claims accurately. However, program offices in VBA and VHA did not adequately communicate or share data, contributing to beneficiaries receiving improper payments after their deaths and delays in new beneficiaries being enrolled in health care. Further, individuals with spina bifida and their caretakers did not receive needed information about benefits because VA did not consistently reach out and accurately communicate with them. The OIG made four recommendations related to preventing payments to deceased beneficiaries through better coordination between the Denver VBA regional benefits office and VHA’s Office of Community Care, ensuring all eligible beneficiaries are promptly enrolled in health care, making certain that agents for national call centers consistently provide accurate and comprehensive benefits information, and engaging eligible beneficiaries who are not aware of or using services.

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 Benefits Administration (VBA),Veterans Health Administration (VHA)
The OIG recommended that the under secretary for benefits and the under secretary for health formalize interagency sharing processes between the Veterans Benefits Administration’s Denver regional office and the Veterans Health Administration’s Office of Community Care on how data and information will be shared between both offices to prevent payments from continuing to deceased spina bifida beneficiaries.
No. 2
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA),Veterans Health Administration (VHA)
The OIG recommended that the under secretary for benefits and the under secretary for health take the following actions establish clear written guidance on sharing beneficiary data between the Veterans Benefits Administration’s Denver regional office and the Veterans Health Administration’s Office of Community Care to ensure all entitled beneficiaries are enrolled in health care.
No. 3
Closed and Implemented Recommendation Image, Checkmark
to Veterans Benefits Administration (VBA)
The OIG recommended that the under secretary for benefits institute standardized procedures to help the Veterans Benefits Administration’s national call center agents provide accurate and comprehensive information about spina bifida benefits.
No. 4
Closed and Implemented Recommendation Image, Checkmark
to Veterans Health Administration (VHA)
The OIG recommended that the under secretary for health direct the Veterans Health Administration’s Office of Community Care to develop a process to ensure those beneficiaries who are not using the services for which they are eligible, or need assistance with locating those services, receive them.