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Open Recommendations

Electronic Health Records: VA Making Incremental Improvements in New System but Needs Updated Cost Estimate and Schedule
GAO-25-106874
Mar 12, 2025
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3 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of VA should direct the EHRM Integration Office to obtain an updated and independent total life cycle cost estimate using best practices described in GAO's Cost Estimating and Assessment Guide. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of VA should direct the EHRM Integration Office to expeditiously and reliably update its integrated master schedule using best practices described in GAO's Schedule Assessment Guide. (Recommendation 2)
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When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of VA should direct the EHRM Integration Office and the VHA to identify baselines and performance targets for all nine identified metrics intended to measure program and system performance. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Health Care: Actions Needed to Improve the Foreign Medical Program
GAO-25-107149
Feb 19, 2025
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9 Open Recommendations
Agency Affected Recommendation Status
Veterans Health Administration The Under Secretary for Health should, in coordination with the Foreign Medical Program, develop and implement a modernization plan for the program's legacy claims processing system, including milestones, a description of the work necessary, and details on the disposition of the legacy system. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should, in coordination with the Foreign Medical Program, finalize the necessary steps to transition to electronic funds transfers and immediately prioritize their implementation in coordination with the Department of the Treasury, as appropriate. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should, in coordination with the Foreign Medical Program, evaluate and implement as appropriate strategies to help mitigate staffing challenges that affect the Foreign Medical Program. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should, in coordination with the Foreign Medical Program, designate a dedicated entity for managing the process of assessing fraud risks to the program, consistent with leading practices. This entity should have, among other things, clearly defined and documented responsibilities, and authority for managing fraud risk assessment for the program. (Recommendation 4)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should, in coordination with the Foreign Medical Program, regularly identify inherent fraud risks in the program and coordinate with external stakeholders, such as the Department of the Treasury, as appropriate. (Recommendation 5)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Veterans Health Administration The Under Secretary for Health should, in coordination with the Foreign Medical Program, assess the likelihood and impact of inherent fraud risks in the program. (Recommendation 6)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Health Care: Referral Coordination Initiative for Specialty Care Needs Improved Program Direction and Guidance
GAO-25-106678
Feb 10, 2025
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5 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Under Secretary for Health should ensure that IVC defines RCI program direction—strategic goals, roles and responsibilities, standards for consistent implementation, and oversight and accountability—in appropriate VHA national policy. (Recommendation 1)
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When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health, upon inclusion of the RCI in the appropriate VHA national policy, should ensure that IVC aligns RCI guidance with VHA national policy and updates it as needed to reflect available evidence, such as findings from studies, best practices, and other elements that promote consistent implementation. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health, following initial alignment of RCI guidance and national policy, should ensure that IVC establishes a process to ensure that any guidance remains current and accurate when IVC makes changes to RCI policy or program requirements. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health should ensure that IVC reviews the RCI performance metrics, and updates them as needed, to ensure that the metrics align with and assess progress toward all aspects of RCI's strategic goals. (Recommendation 4)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Under Secretary for Health should ensure that IVC communicates with VISNs and VHA facilities regarding how to use its metrics to measure performance toward the RCI goals. (Recommendation 5)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.

Veterans Community Care Program: VA Needs to Strengthen Contract Oversight
GAO-24-106390
Aug 21, 2024
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3 Open Recommendations
Agency Affected Recommendation Status
Department of Veterans Affairs The Secretary of VA should ensure that the Assistant Under Secretary for Health for IVC establishes a complete set of documentation for oversight of the Community Care contracts, including documentation of clear and complete procedures and the identification of roles and responsibilities. (Recommendation 1)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of VA should ensure that the Assistant Under Secretary for Health for IVC assesses whether the oversight and reporting responsibilities of the program manager position outlined in the Quality Assurance Surveillance Plans are being effectively fulfilled by current processes and, if not, updates the plans as appropriate. (Recommendation 2)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
Department of Veterans Affairs The Secretary of VA should ensure that the Assistant Under Secretary for Health for IVC develops a formal lessons learned process, consistent with leading practices, for the Community Care contracts to inform VA's plans for the next set of contracts and its continuing oversight efforts. (Recommendation 3)
Open
When we confirm what actions the agency has taken in response to this recommendation, we will provide updated information.
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