Audit of the Beneficiary Travel Program, Special Mode of Transportation, Eligibility and Payment Controls

The purpose of the Beneficiary Travel Program is to help alleviate the costs of travel to medical appointments for eligible veterans. Under this program, VA has the authority to pay travel expenses including mileage traveled by an eligible veteran to and from a VA-approved facility for the purpose of examination, treatment, or care. The Veterans Health Administration (VHA) also uses vendors to transport eligible beneficiaries with disabilities using vehicles approved for special mode of transportation (SMT) travel. SMT-approved vehicles include ambulances, air ambulances, wheelchair vans, or other modes of transportation that are specifically designed to transport disabled individuals. The OIG found VA Medical Centers (VAMCs) authorized SMT services for some ineligible beneficiaries, and VAMCs did not adequately validate some SMT vendor invoices prior to authorizing payment. VHA also missed an opportunity to reduce program expenditures on ambulance services by paying more than rates authorized by law for SMT services. VAMCs also allowed some beneficiaries that used SMT services to improperly receive mileage reimbursements for the same appointments. The OIG estimated VAMCs improperly authorized SMT services for 11,900 ineligible beneficiaries and VHA made 59,900 improper payments nationwide valued at $23 million to SMT vendors from October 1, 2014, through December 31, 2015. The OIG also estimated VHA could have saved $11 million from October 1, 2012, through December 31, 2015, by paying Centers for Medicare and Medicaid Services rates for ambulance services. In addition, the OIG estimated VHA made approximately $229,000 in improper payments to beneficiaries for mileage reimbursements when SMT services were also used from October 1, 2014, through December 31, 2015. If oversight controls are not strengthened, improper payments for SMT services may cost taxpayers approximately $173.8 million through December 31, 2020.