WASHINGTON — Fake appointments, unofficial logs kept on the sly and appointments made without telling the patient are among tricks used to disguise delays in seeing and treating veterans at Veterans Affairs hospitals and clinics.
They’re not a new phenomenon. VA officials, veteran service organizations and members of Congress have known about them for years.
The “gaming strategies” were used to make it appear veterans were getting appointments within target times set by the department, according to a 2010 department memo to VA facility managers aimed at fighting the practices.
The memo from William Schoenhard, then the VA’s deputy undersecretary for health operations and management, said that when a medical appointment wasn’t available within the 30-day target time then used by VA, some schedulers would:
Make a fake appointment within the 30-day period but not tell the patient. The appointment would be canceled later and a new appointment would be made to meet a new 30-day target.
Note on a paper log the actual distant date of an appointment, but not enter it into computer until within 30 days of the date.
Give the patient an appointment at whatever date was next available, but log it in the computer as the date the veteran had asked for.
Long wait times for VA services were politically toxic. So politicians put pressure on bringing the wait time metric down to a reasonable number. Not surprisingly, that largely led to focusing on how to bring the number down, not the actual wait time.
Question for the legal eagles out there. If a VA employee used these measures to achieve a metric, and were rewarded with a financial bonus, does that rise to the legal definition of fraud? Can the employee be held criminally liable?