PHOENIX - An audit by the Veterans Affairs health care network in the Southwest shows officials knew years ago that employees were manipulating data on doctor appointments.
The 2012 audit and other records obtained by The Arizona Republic found hospitals and clinics in Arizona, New Mexico and western Texas chronically violated department policy and created inaccurate data on patient wait times using a variety of methods despite a national directive to stop the practices.
With wait times rigged, VA employees were able to get bonuses for appearing to meet goals to reduce delays in patient care. At the Phoenix medical center, the bonuses totaled more than $10 million over the past three years.
Top officials at the Phoenix VA, including Sharon Helman, who was suspended as director last month, have repeatedly claimed they were not aware of scheduling misconduct until whistle-blower complaints were made public in April.
Audit findings show the scheduling schemes and other violations of department policy proliferated throughout the Southwest and were common nationwide.
Officials with the VA center in Albuquerque have repeatedly denied having secret waiting lists but acknowledged only recently that the system in New Mexico has problems with waiting times.
The findings of a 2013 investigation trigged by another whistle-blower complaint show schedulers in Albuquerque received scripts to follow when negotiating appointment times with veterans. There were also lists in which schedulers would cancel medical appointments and remake them to reflect acceptable wait times.
"These documents ... were distributed solely as lists to be used to `clean up' or `fix' appointments that did not fall within acceptable wait time parameters," according to a report of the internal investigation obtained by the Albuquerque Journal. (http://bit.ly/1nu90aq ).
The report also stated that the inappropriate scheduling practices had been going on for a decade or more.
Allegations that dozens of veterans died while awaiting appointments at the Phoenix VA medical center first triggered the national uproar over the VA and subsequent calls by congressional delegations in Arizona, New Mexico and elsewhere for independent investigations.
U.S. Rep. Michelle Lujan Grisham, D-N.M., is among those calling for a broader inquiry. She said she wants to know who should be held accountable for directing employees in New Mexico and others states to manipulate the scheduling.
"Why would we see this happening at more than one VA hospital? I think people are afraid of retaliation," she said.
The audit obtained by the Arizona newspaper noted that former VA Undersecretary Robert Petzel, who resigned in May, convened a conference call in 2011 with top leaders nationwide to confront the problem. Petzel had pressed department executives "not to `game' the system."
William Schoenhard, another VA deputy undersecretary, discussed various methods for manipulating the system a year earlier. He directed top regional administrators to ensure the integrity of the scheduling system and to conduct annual reviews.
E-mails between Arizona VA officials show they were intensely aware of scheduling compliance problems throughout 2013. Still, in a December letter to U.S. Sen. John McCain, R-Ariz., Helman discounted the whistle-blower claims.
U.S. Rep. Jeff Miller, R-Fla., chairman of the House Committee on Veterans' Affairs, told The Republic that the new revelations offer "continued proof of how VA leaders looked the other way while bureaucrats lied, cheated and put the health of veterans they were supposed to be serving at risk."