Department of Veterans Affairs

Randomly Check Accuracy of Eligibility Claims

Create a local Quality Assurance Panel in each VA to randomly check the accuracy of claims for eligibility. If we can identify where the holes are in each VA, we will then know how to close that hole.

 

For each pt who fraudulently applies for and is granted eligibility for health care benefits, there is a cascade effect: pt not only gets inpt stays, costly medications, dental work, etc. but can then apply for housing, education, claim they "lost" their VA ID and obtain a "replacement" card that was never issued. Then the person can go to Soc.Sec Admin. who will accept VA ID card as valid. Criminals know how to do this. The VA is sloppy and/or uneducated about eligibility requirements and acceptable documentation.

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Idea No. 16405