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Texas VA run like a 'crime syndicate,' whistleblower says

Texas VA run like a 'crime syndicate,' whistleblower says

Editor's Note: This story has been updated with new information.

Last week, President Obama pledged to address allegations of corruption and dangerous inefficiencies in the veterans’ health-care system. But before the president could deliver on his pledge, the scandal has spread even further. New whistleblower testimony and internal documents implicate an award-winning VA hospital in Texas in widespread wrongdoing—and what appears to be systemic fraud.

Emails and VA memos obtained exclusively by The Daily Beast provide what is among the most comprehensive accounts yet of how high-level VA hospital employees conspired to game the system. It shows not only how they manipulated hospital wait lists but why—to cover up the weeks and months veterans spent waiting for needed medical care. If those lag times had been revealed, it would have threatened the executives’ bonus pay.

What’s worse, the documents show the wrongdoing going unpunished for years, even after it was repeatedly reported to local and national VA authorities. That indicates a new troubling angle to the VA scandal: that the much touted investigations may be incapable of finding violations that are hiding in plain sight.  

“For lack of a better term, you’ve got an organized crime syndicate,” a whistleblower who works in the Texas VA told The Daily Beast. “People up on top are suddenly afraid they may actually be prosecuted and they’re pressuring the little guys down below to cover it all up.”

“I see it in the executives’ eyes,” the whistleblower added. “They are worried.”

The current VA scandal broke in Phoenix last month, when a former doctor at a VA hospital there became the first whistleblower to gain national attention. The doctor's allegations of falsified appointments—and veterans dying while they waited for treatment—unleashed a wave of similar claims from VA employees nationwide. In Cheyenne, Wyoming, Chicago, and Albuquerque, more VA whistleblowers came forward claiming that the same fraudulent scheduling was being used in the hospitals where they worked. At last count, the VA inspector general’s investigation had expanded to 26 separate facilities.

The torrent of claims led to Senate hearings, calls for VA Secretary Eric Shinseki to resign, multiple investigations and President Obama’s own public statement last week. Paul Rieckhoff, founder and chief executive officer of Iraq and Afghanistan Veterans of America (IAVA), believes that even more revelations are coming.

“This newest case just further illustrates that the scandal is much more far reaching than most people realize,” Rieckhoff said, “Phoenix was just the tip of the iceberg. Scandal has become the new normal, it’s the status quo at the VA right now.”

But, despite the political uproar and the growing investigations, the root causes of the VA crisis have remained murky. New documents and whistleblower testimony obtained by The Daily Beast shed light on exactly how fraud is being perpetrated in the VA and its underlying causes.

There’s enormous pressure to report favorable wait times for VA patients, the Texas whistleblower explained, even if those wait times are completely false.

“If [VA] directors report low numbers, they’re the outlier. They won’t stay a director very long and they certainly won’t get promoted. No one is getting rewarded for honesty. They pretty much have to lie, if they don’t they won’t go anywhere,” the whistleblower added. Weighted more heavily than other performance measures, the wait time numbers alone “count for 50% of the executive career field bonus, which is a pretty powerful motivator.”

Though VA hospitals may be struggling with increasing patient loads and inadequate resources—including too few medical providers—they are punished for acknowledging those problems. The VA’s current system appears to reward executives’ accounting tricks that mask deep structural issues and impede real solutions.

The whistleblower—who will alternately be called “the clinician,” referring to the job they have held with the Texas VA for almost a decade—asked to remain anonymous due to fear of losing their job or being otherwise punished for speaking out.

ANATOMY OF A FRAUD

The clinician has been alerting authorities to the wrongdoing at their facility for years but the corruption has persisted despite multiple reports and investigations by the VA’s inspector general.

The case of Dr. Joseph Spann, a recently retired doctor who reported malfeasance in the Texas VA system, where he worked for 17 years, raises the possibility that official investigations may only be hiding the problems they were charged to root out.

After retiring in January of this year Spann sent a letter to VA investigators accusing a VA employee of manipulating patient wait lists to hide treatment delays for veterans. The rigged reporting scheme Spann described in his letter, which threatens veterans’ lives by delaying their treatment, is the same method that has been exposed in Phoenix, Cheyenne, Albuquerque, and scores of other VA hospitals across the country.

According to Spann, Dr. Gordon Vincent, chief of radiology at Olin E. Teague Veterans Medical Center in Temple, Texas, didn’t just break VA policy by manipulating veterans’ appointments himself. He ordered VA employees across the state to engage in the same fraudulent practice.

The VA said it investigated Spann’s charges, and, after, finding nothing to substantiate the claims, cleared Vincent and the Texas VA.

But documents obtained by The Daily Beast appear to show Dr. Vincent doing precisely what Spann accused him of—the activities the VA said it could not substantiate.

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