GAO Audit Reveals VA Slashed Improper Private-Care Payments by Nearly All Since 2020
A GAO audit found the VA reduced improper payments for community care by 98% since 2020, citing stronger billing controls.
The Department of Veterans Affairs has cut improper payments tied to its community care program — which covers private-sector health services for veterans — by 98 percent since 2020, according to a Government Accountability Office audit reviewed by Military Times. The finding marks one of the more significant administrative turnarounds in recent VA history, reflecting years of pressure from Congress and watchdog agencies to close the billing vulnerabilities that had allowed erroneous payments to flow through the department’s third-party care infrastructure. The GAO’s assessment is notable given longstanding criticism of the VA’s fiscal controls — an oversight landscape that intersects with the same broader accountability pressures shaping other defense-adjacent agencies, including those covered in GDD’s reporting on National Guard leadership.
The community care program, established under the VA MISSION Act of 2018, allows veterans to seek treatment from private providers when VA facilities cannot meet their needs in a timely or geographically accessible manner. The scale of the program — and the complexity of billing through third-party administrators — created conditions in which improper payments became a persistent audit concern. The GAO’s finding that those payments have been reduced by 98 percent since 2020 suggests the corrective measures implemented over that period have been substantively effective, though the audit’s precise dollar figures and the remaining residual error rate were not fully detailed in the reporting available to GDD.
Controls That Drove the Reduction
The VA attributed the improvement in part to enhanced payment integrity processes, including stronger pre-payment review mechanisms and improved coordination with its third-party administrators who handle billing on behalf of private providers. Officials indicated the department invested in both technology and procedural oversight to catch erroneous claims before disbursement rather than attempting to recover funds after the fact. That shift toward pre-payment controls is widely regarded in government auditing circles as more effective than clawback-based approaches, which depend on identifying and litigating overpayments after they have already been made to providers.
The GAO did not characterize the remaining improper payment rate as fully resolved, and it was not confirmed in available reporting whether the office issued formal recommendations alongside its findings or whether the VA received a clean bill of health across all community care billing categories. The VA has historically struggled with the administrative complexity of reconciling claims submitted by a geographically dispersed network of private physicians, hospitals, and specialty providers — a challenge that the MISSION Act’s expanded eligibility criteria compounded significantly after 2019.
What the Finding Means for Veterans Policy
The 98 percent reduction carries weight beyond the VA’s internal accounting. Community care spending represents one of the fastest-growing cost centers in the department’s budget, and improper payments in that program have drawn repeated congressional scrutiny. Demonstrating that billing integrity has improved at scale strengthens the VA’s position in budget negotiations and may reduce pressure for more restrictive legislative oversight of how private-care funds are disbursed. It also provides a degree of validation for the administrative architecture built around the MISSION Act, which faced early skepticism about whether the VA could manage an expanded network of outside providers without significant fiscal leakage.
For veterans themselves, the audit’s findings are more indirect in their impact. Improper payments in the community care context typically involve overpayments or duplicate payments to providers rather than benefit denials to patients, meaning the reduction in errors does not necessarily translate to changes in access or care quality. What it does signal is that the department’s payment infrastructure is operating with considerably greater precision — a prerequisite for any future expansion of private-care eligibility that policymakers on both sides of the aisle have continued to debate. The VA has not publicly announced additional reforms in response to the GAO report, and officials have not confirmed a target timeline for eliminating the remaining error margin entirely.
