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OIG Tells Subcommittee VA’s Program Integrity Tool Pause Hobbled Fraud Detection; Lawmakers Back IT-Based Countermeasures
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Summary
The VA Office of Inspector General described a pause in the Program Integrity Tool (PIT) that limited fraud detection and revenue collection; members and witnesses discussed H.R. 3483, the Fraud Act, to require an IT system to detect overpayments in community care claims.
The House Veterans' Affairs Subcommittee heard testimony from the VA Office of Inspector General that a pause in the department’s Program Integrity Tool (PIT) reduced the VA’s ability to detect fraud, waste and abuse in community care payments and hampered revenue collection.
"The pause was intended to allow VHA time to evaluate the tool's processes, data, and its underlying IT system to determine the causes of any data errors and identify improvement opportunities," Dr. Jennifer McDonald said, describing why VHA halted the tool in February 2023.
Dr. McDonald told lawmakers that while the PIT was offline, VHA’s ability to collect revenue from veterans’ co‑payments and private insurers was limited by more than $660 million and that staff were left to review tens of millions of claims manually.
Representative Barrett (R‑Mich.), sponsor of the Forcing Real Accountability for Unlawful Distributions through the Fraud Act of 2025 (H.R. 3483), told the panel the bill would require the VA to acquire an information‑technology system capable of analyzing community care claims to detect over‑payments and indicators of fraud.
Ms. Laura Duke, Chief Financial Officer for VHA, said the VA supports the intent of the Fraud Act and estimates that savings from preventing overpayments could "more than pay for the technologies and services to fully recover all the costs," but she recommended technical adjustments to ensure the bill covers claims at highest risk.
Members and witnesses agreed there are practical challenges. Duke and other VA witnesses said identifying criminal intent can exceed the department’s authorities and that enforcement of fraud allegations typically involves the Department of Justice and other law‑enforcement entities. Ms. Duke said a detection system would help prioritize recoupment efforts and focus investigations.
The OIG emphasized the need for adequate staffing and resources to act on IT findings. Dr. McDonald said the OIG’s July 2024 memorandum described the "major impacts of the tool's pause on VHA's revenue collection processes and on identifying fraud, waste, and abuse related to community care claims." OIG testimony noted the program integrity tool remained only partially used for prevention, detection, and mitigation of fraud as of the hearing.
Representative Barrett said he hopes technological deterrence would reduce fraudulent billing and that the law could be structured so the VA’s franchise fund or other mechanisms cover acquisition costs. VA witnesses and OIG agreed to work with the subcommittee on amendments and technical fixes to the proposed legislation.
