Metro East Sun

On September 19, 2024, Rep. Matt Rosendale (R-Mont.), Chairman of the House Committee on Veterans’ Affairs Subcommittee on Technology Modernization, delivered opening remarks at the subcommittee’s oversight hearing titled “VA’s Open Cash Register: Fraud, Waste, Abuse and Revenue Operations.” The hearing aimed to scrutinize the Department of Veterans Affairs' (VA) difficulties in operating IT systems crucial for preventing fraud, waste, and abuse in VA community care payments and collecting insurance payments and copays.

Rosendale highlighted the significance of the Program Integrity Tool (PIT), which consolidates all community care claims payment data. He noted that PIT serves two primary functions: preventing fraud, waste, and abuse when paying community care providers’ claims and billing and collecting for non-service-connected care. According to Rosendale, over 90% of these medical collections come from insurance company billings.

Rosendale stated that without PIT, "VA is essentially operating an open cash register," lacking controls on outgoing cash and failing to collect due change. This situation began in February 2023 when technical defects forced VA to shut down PIT. Despite efforts to restore functionality by July this year, unresolved issues persist.

The Office of Inspector General estimated that more than $665 million in revenue was not collected—primarily owed by insurance companies—and millions of dollars in fraud, waste, and abuse went undetected during this period. Rosendale criticized the handling of PIT's issues as marked by "unsteady leadership, questionable decision making, and terrible contractor performance."

Chairman Bost had previously sent a letter to Secretary McDonough on July 30th with detailed questions about PIT's failures but received an unsatisfactory response from Mr. DelBene on September 6th. Rosendale emphasized Congress's constitutional duty to question the Executive Branch and requested a full written response from VA.

Rosendale also pointed out a reported $12 billion shortfall in VHA's budget for next year. He mentioned that VA provided arithmetic details only recently and that conflicting information exists regarding whether delayed medical collections contribute to this shortfall.

The improper payment rate for community care stands at 4.9%, translating into over $1.5 billion annually in improper payments out of a $31 billion program. Additionally, missed collections amount to nearly $1 billion over 18 months.

Concluding his remarks, Rosendale asserted that IT system failures should not justify wasting taxpayers' money and expressed confidence that Congress would address the health care shortfall without undermining veterans' care.

He then yielded the floor to Ranking Member Cherfilus-McCormick for her opening statement.

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