Spending by the Department of Veterans Affairs on care provided by non-VA providers on a fee-basis increased from about $3.04 billion in fiscal 2008 to about $4.48 billion in fiscal 2012, but the department has not established goals for and does not track how long veterans wait to be seen by fee basis providers, GAO has said in calling for management and oversight improvements for this kind of care.
VA’s fee basis care utilization also increased from about 821,000 veterans in fiscal 2008 to about 976,000 veterans in fiscal 2012, and GAO found that several drivers that impact VA medical centers’ utilization of fee basis care, including veteran travel distances to VAMCs and goals for the maximum amount of time veterans should wait for VAMC-based appointments.
The department’s monitoring of fee basis care spending is limited because fee basis data do not currently include a claim number or other identifier that allows all charges from a single office visit with a fee basis provider or an inpatient hospital stay to be analyzed together, according to GAO-13-441.
It said that without the ability to analyze spending in this way, VA is limited in its ability to assess the cost of fee basis care and verify that fee basis providers were paid appropriately.
The VA generally agreed with recommendations to revise its beneficiary travel regulations to allow reimbursement for veterans seeking similar care from a fee basis provider, apply the same wait time goals to fee basis care as VAMC-based care, and ensure fee basis data includes a claim number.