GAO: VA's use of medical injury tort claims lacks data completion

Although the Department of Veterans Affairs' (VA) regional counsel offices are required to notify Office of Medical-Legal Affairs (OMLA) about all paid tort claims to initiate OMLA's review of VA practitioners involved in the claims, the U.S. Government Accountability Office (GAO) found that this notification does not always occur because VA lacks an internal control to help ensure that regional counsel offices comply with this requirement.

"Specifically, we found that the regional counsel offices did not report to OMLA 16 percent of the total number of paid tort claims involving VA practitioners from fiscal years 2005 through 2010," an October report from GAO stated. "VA Office of General Counsel (OGC) officials told us that this occurred for several reasons, such as lack of administrative oversight and staff turnover."

As a result, OMLA did not have the opportunity to review all paid tort claims for this time period to determine whether VA practitioners associated with these claims rendered substandard care, thus limiting the number of practitioners who should have been reported to the National Practitioner Data Bank (NPDB), GAO continued.

Congress asked GAO to examine the resolution of tort claims filed against VA in the context of VA's efforts to improve the quality of veterans' care at its facilities.

From fiscal years 2005 to 2010, the number of tort claims filed against VA rose by 33 percent, from 1,251 to 1,670. Most tort claims filed against VA in fiscal years 2005 through 2010 were resolved through VA's administrative review, rather than through litigation, GAO stated. Specifically, VA resolved more than 80 percent of tort claims through administrative review during this 6-year period, and the remainder were resolved through litigation.

The amount paid for tort claims during fiscal years 2005 through 2010 was lower for claims resolved through administrative review than for claims resolved through litigation, according to the report. "For example, in fiscal year 2010, about $30 million was paid for the 277 tort claims that were resolved through VA's administrative review, while about $49 million was paid for the 114 claims that were resolved through litigation."

Further, in fiscal year 2010 the average number of days to resolve tort claims administratively was considerably less than the average number of days it took to resolve claims through litigation, the agency added.

To help ensure the quality of care provided to veterans by VA practitioners, GAO recommends that the secretary of VA direct the general counsel to take three actions:
  • Ensure that regional counsel offices notify OMLA about all paid tort claims resolved through VA's administrative review and through litigation;
  • Develop and implement an internal control process to verify the completeness of the notifications of paid tort claims that regional counsel offices provide to OMLA; and
  • Review all paid tort claims related to medical injuries at VA facilities in prior years to ensure that all of these claims are reported to OMLA.

Read the full report here.

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