Revelations by the Washington Examiner of a mass purge of backlogged medical appointments by the Department of Veterans Affairs were dismissed as a “scurrilous newspaper report” by the agency’s top health official Wednesday.
Robert Petzel, under secretary for health at the veterans agency, said only a few hundred unneeded tests were administratively cancelled at Los Angeles medical facilities several years ago.
Rep. Tim Huelskamp, R-Kan., held up the story published Tuesday by the Examiner documenting the cancellation of 40,000 procedures in Los Angeles and 13,000 in Dallas as he grilled Petzel during a hearing of the House Veterans Affairs Subcommittee on Health.
The numbers cited by the Examiner are based on prior congressional hearings and the VA’s own internal documents.
Petzel responded that only 300 requests for consultation or X-rays were administratively closed as a result of an extensive review of old diagnostic orders in Los Angeles.
“There was nobody who needed the care that was denied the care,” Petzel said. “There was no attempt to eliminate a backlog by destroying records. You can’t destroy the records.”
Questioned by reporters about the numbers disparity after the hearing, Petzel said the 300 cancelled tests were for “radiology examinations” at the Los Angeles facilities. He said he has never heard the figures cited by the Examiner.
Those numbers were raised by Rep. Mike Coffman, R-Colo., during a March 2013 congressional hearing. Two of Petzel’s top deputies did not dispute the numbers when questioned by Coffman during that hearing.
“My concern is that VA has or will clear this backlog by simply administratively closing appointments, as they did with 13,000 appointments in Dallas and approximately 40,000 appointments in Los Angeles,” said Coffman.
Coffman is chairman of the House Veterans Affairs Subcommittee on Oversight and Investigations.
Phillip Matkovsky, assistant deputy under secretary for health at VA, told Coffman last year that no valid appointments were cancelled. Matkovsky was sitting with Petzel at the witness table Wednesday.
In addition to the congressional hearing, the Examiner obtained an internal VA document dealing with the Dallas purge, stating that 13,000 orders for medical procedures, called “unresolved consults,” were administratively closed in about a week's time in September 2012.
The stated purpose was to “aggressively address this backlog of unresolved consults and reduce the number to an acceptable level.”
Click to read the transcript of the March 2013 hearing.
Click to view the VA document about the purge in Dallas.
The Examiner story linked the massive purge of medical appointments to a pattern at Veterans Affairs of falsifying reported wait-times to make it appear individual medical centers were meeting deadlines set by agency policy.
Performance reviews and bonuses of top administrators are linked to meeting those goals.
VA made 19 “institutional disclosures” between September 2012 and March 2013 related to patient deaths because of delayed endoscopy procedures at veterans’ hospitals nationwide.
At least six preventable deaths have been linked to delayed colonoscopies in Columbia, S.C.
Oliver Mitchell, an ex-Marine and former scheduling clerk at the VA Greater Los Angeles Medical Center, told the Examiner he was ordered to begin a massive purge of backlogged medical appointments in November 2008. He refused.
Mitchell filed a whistleblower complaint with the agency’s inspector general and with the U.S. Office of Special Counsel in 2009, saying he was aware of 20,000 tests that were improperly cancelled at the facility.
The Examiner also cited a Government Accountability Office investigation that found repeated instances in which appointment dates for medical tests and procedures were falsified to meet agency performance goals.
At Wednesday’s hearing, Huelskamp asked whether anyone had been disciplined for falsifying those records.
Matkovsky responded he attempted to verify GAO's findings, but was unsuccessful.
“We were not able to find concrete evidence that the GAO had,” Matkovsky said, adding GAO did not turn over specifics as to who was interviewed in its investigation. “We could not find the concrete evidence to engage in the appropriate disciplinary action.”
The Examiner sent a detailed list of questions about the administrative closure of medical consultations to VA officials February 21.
They did not respond until after the hearing Wednesday, and even then did not answer the specific questions about when the purge was authorized and how many appointments had been administratively closed nationwide.
A posting on the VA’s Facebook page echoes Petzel’s testimony, saying “some media reports on this issue have been inaccurate.”
Huelskamp said after the hearing he has no faith in any of the numbers VA is providing.
“It's hard to believe these folks when they are clearly covering up data,” Huelskamp told the Examiner. “How do you hold people accountable when you don't believe the numbers they are providing us? It's hard to trust the information coming out of there.”