VA Health Care

More than 100 Department of Veterans Affairs (VA) medical centers contract with outside medical specialists, mainly for radiology and anesthesiology services. Contracting costs have mushroomed from $17 million in fiscal year 1985 to more than $80 million in fiscal year 1991. The VA Inspector General, citing inadequate contracting procedures as the cause, reported in 1987 that the medical centers were paying millions of dollars for services that either were unneeded or had never been delivered. VA needs to beef up oversight of medical specialist contracts. Due to a lack of data and evaluation criteria for contract proposals, however, it cannot identify medical centers with contracting problems. VA recognizes that major weaknesses persist in contracting for medical specialists and appears committed to making necessary improvements. GAO summarized this report in testimony before Congress; see: VA Health Care: Inadequate Controls Over Scarce Medical Specialist Contracts, by David P. Baine, Director of Federal Health Care Delivery Issues, before the Subcommittee on Oversight and Investigations, House Committee on Veterans' Affairs. GAO/T-HRD-92-50, Aug. 5, 1992 (nine pages).

GAO found that: (1) VA has not sufficiently improved its controls over medical specialist contracts to ensure that medical centers are avoiding contracting problems; (2) medical centers are not adequately justifying or providing adequate data for their proposed contracts; and (3) VA does not ensure that medical centers are making required contract modifications.

Recommendations

Our recommendations from this work are listed below with a Contact for more information. Status will change from "In process" to "Open," "Closed - implemented," or "Closed - not implemented" based on our follow up work.

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