GAO tells House subcommittee VA overpaid contractors and needs stronger checks on disability exams
November 21, 2025 | Veterans Affairs: House Committee, Standing Committees - House & Senate, Congressional Hearings Compilation
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The House Veterans' Affairs subcommittee heard Tuesday that the Department of Veterans Affairs's oversight of contracted disability exams has persistent gaps that have harmed veterans and cost taxpayers. Elizabeth Curta, director for Education, Workforce and Income Security at the Government Accountability Office, told members the GAO found breakdowns in how the Medical Disability Examination Office (MDEO) calculates incentive payments and tracks exam quality.
"VBA overpaid almost $2,300,000 in financial incentives in the first quarter of fiscal year 2024," Curta said, and GAO found the office lacked written procedures and automated verification to ensure accuracy. GAO recommended five steps to strengthen prevention, detection and correction of exam errors, including written checks on incentive calculations and direct collection of feedback from contracted examiners.
Mary Glenn, deputy director of the MDEO at the Veterans Benefits Administration, told the panel that VA has taken corrective steps. "MDEO has recouped the overpayments mentioned in the report, enhanced our methodology to prevent future errors, and implemented all recommendations," she said, and requested closure of the GAO recommendations once VA's actions are verified. Glenn said VA audited incentive and disincentive payments back to fiscal year 2022 after GAO flagged the issue and has moved from a manual approval process to automated checks and an audit contract.
Members pressed for more detail on scale and controls. Committee members noted the size of the program'more than 3.3 million scheduling requests and roughly 4 million appointments in FY2025'and asked how much VA pays vendors annually and how costs compare to exams performed in-house. Glenn said she would provide total payments and cost-per-exam comparisons after the hearing. GAO and members also emphasized the program's national scale: GAO testified contractors performed about 93 percent of exams at a cost GAO estimated in the billions.
Beyond incentive calculations, witnesses and members discussed several problem areas: scheduling and rescheduling failures that leave veterans without timely appointments; instances where examiners lacked required specialty training; accessibility barriers at contracted facilities highlighted in a 2024 OIG site-visit report; and questions about the timing of special focus reviews (SFRs) of the most complex claims, such as traumatic brain injury and military sexual trauma. GAO said VA planned to move SFRs from a two-year cadence to three years because of staffing constraints, a change several members and Curta warned would reduce opportunities for timely course corrections.
Glenn described operational changes intended to address these gaps: restoration of a financial-audit contract, deployment of a veteran-experience survey, the launch of an examiner feedback portal accessible through VA's learning management system, and plans to evaluate advanced clinical and evidence-review tools to reduce some in-person exams. She also cited contract provisions that limit vendor travel (50 miles for general exams, 100 miles for specialty exams), mobile units and license portability extensions that allow clinicians to serve across state lines as measures to improve access.
Several members called for direct accountability from contractors, including asking the committee to invite vendor leaders to testify and to hold roundtables. Lawmakers repeatedly framed the issue as both a veterans'care problem and a taxpayer-protection issue: Curta told the panel that incomplete or inaccurate exams can produce incorrect claims decisions, leading to rework, delays and higher costs.
The hearing ended with the chair requesting follow-up materials from witnesses and saying the committee would continue oversight. Members were granted five legislative days to submit revisions and the record was left open for additional documents.
The committee did not take any votes during the hearing. The subcommittee said it will seek further documentation on total vendor payments, penalties assessed, and the status of implementation for GAO's recommendations.
"VBA overpaid almost $2,300,000 in financial incentives in the first quarter of fiscal year 2024," Curta said, and GAO found the office lacked written procedures and automated verification to ensure accuracy. GAO recommended five steps to strengthen prevention, detection and correction of exam errors, including written checks on incentive calculations and direct collection of feedback from contracted examiners.
Mary Glenn, deputy director of the MDEO at the Veterans Benefits Administration, told the panel that VA has taken corrective steps. "MDEO has recouped the overpayments mentioned in the report, enhanced our methodology to prevent future errors, and implemented all recommendations," she said, and requested closure of the GAO recommendations once VA's actions are verified. Glenn said VA audited incentive and disincentive payments back to fiscal year 2022 after GAO flagged the issue and has moved from a manual approval process to automated checks and an audit contract.
Members pressed for more detail on scale and controls. Committee members noted the size of the program'more than 3.3 million scheduling requests and roughly 4 million appointments in FY2025'and asked how much VA pays vendors annually and how costs compare to exams performed in-house. Glenn said she would provide total payments and cost-per-exam comparisons after the hearing. GAO and members also emphasized the program's national scale: GAO testified contractors performed about 93 percent of exams at a cost GAO estimated in the billions.
Beyond incentive calculations, witnesses and members discussed several problem areas: scheduling and rescheduling failures that leave veterans without timely appointments; instances where examiners lacked required specialty training; accessibility barriers at contracted facilities highlighted in a 2024 OIG site-visit report; and questions about the timing of special focus reviews (SFRs) of the most complex claims, such as traumatic brain injury and military sexual trauma. GAO said VA planned to move SFRs from a two-year cadence to three years because of staffing constraints, a change several members and Curta warned would reduce opportunities for timely course corrections.
Glenn described operational changes intended to address these gaps: restoration of a financial-audit contract, deployment of a veteran-experience survey, the launch of an examiner feedback portal accessible through VA's learning management system, and plans to evaluate advanced clinical and evidence-review tools to reduce some in-person exams. She also cited contract provisions that limit vendor travel (50 miles for general exams, 100 miles for specialty exams), mobile units and license portability extensions that allow clinicians to serve across state lines as measures to improve access.
Several members called for direct accountability from contractors, including asking the committee to invite vendor leaders to testify and to hold roundtables. Lawmakers repeatedly framed the issue as both a veterans'care problem and a taxpayer-protection issue: Curta told the panel that incomplete or inaccurate exams can produce incorrect claims decisions, leading to rework, delays and higher costs.
The hearing ended with the chair requesting follow-up materials from witnesses and saying the committee would continue oversight. Members were granted five legislative days to submit revisions and the record was left open for additional documents.
The committee did not take any votes during the hearing. The subcommittee said it will seek further documentation on total vendor payments, penalties assessed, and the status of implementation for GAO's recommendations.
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