On June 17, 2026, the Department of Veterans Affairs (VA) released an Office of Inspector General (OIG) Audit Report (#25-01014-139).
This Report, entitled: Audit of Veterans Community Care Eligibility Determinations, pointed out significant errors made by the VA’s Veteran Health Administration (VHA) in Community Care eligibility decisions.
In summary, during the first quarter of Fiscal Year (FY) 2025 the VA spent $440 million by incorrectly sending veterans to outside medical providers, under the auspices of the Community Care Program. Based on the $440 million spent for one quarter, the OIG Report estimated the VA unnecessarily spent $1.7 billion annually.
If Community Care eligibility determinations were made accurately by the VHA schedulers, these veterans could have been referred to VA facilities with the same available medical services.
The OIG Audit was made as a requirement of the Senator Elizabeth Dole 21st Century Veterans Healthcare and Benefits Improvements Act. This required the OIG to review the VA’s handling of Community Care eligibility determinations.
During the reviewed FY quarter, the OIG found that 340,000 of 1.4 million veterans referred to Community Care for mental health, primary or specialty care did not meet eligibility requirements. This was approximately twenty-five (25%) percent of all veterans referred.
The OIG indicated that this raised significant concerns on how the VA was managing the Community Care Program, which has grown from $9 billion in 2019 to more than $48 billion in the VA’s FY26 request. This represents an increase of approximately 530%.
To compound the errors in eligibility determinations, the VHA’s schedulers were also guilty for another significant error. That error was not informing some veterans that they were eligible for Community Care.
According to the OIG Report, approximately thirty-eight (38%) percent of 4.8 million veterans, who received care directly from the VA, did not have documented evidence showing they had been assessed for community care eligibility.
That means some veterans may have been sent to outside providers when VA care was available, while others may not have been properly evaluated for outside care when they might have qualified for Community Care.
The OIG determined that if they had been made aware of the next available appointment options at a VA facility and of the Community Care wait times, veterans associated with about 38,100 consults could have received care faster by opting out of community care and taking the next available appointment within VA.
Estimating conservatively, the OIG projected that VA incurred about $114.4 million per year in additional costs because these veterans opted for community care, and it is not clear whether they would have chosen otherwise.
The OIG said the problems were caused in part by guidance from VA’s Office of Integrated Veteran Care that did not align with the MISSION Act.
The OIG Report also indicated that scheduling system limitations prevented staff from seeing appointment availability across all VA medical facilities, while schedulers lacked complete access to community care wait time information.
Ideally, the Community Care Program was expanded to give disabled veterans more options when VA care was unavailable, too far away, or cannot be provided within certain wait-times standards.
The program has also become one of VA’s largest cost and oversight challenges, with lawmakers, watchdogs and veterans’ groups questioning whether the department is accurately determining eligibility and tracking whether veterans are receiving timely care.
The Press Secretary of the VA, Quinn Slaven, stated that the “VA is aware of this issue stemming from the Biden administration,” and the VA Under Secretary of Health concurred with OIG recommendations and submitted corrective action plans to correct the deficiencies.
My Opinion: Who paid for the $440 million errors documented during the first quarter of FY 2025? Taxpayers did! The OIG Report projected, for all four (4) quarters of FY 2025, the amount of taxpayer money unnecessarily spent was $1.7 billion dollars.
The Community Care Program was intended to complement the existing VA Healthcare System. However, the 530 percent increase in the Community Care Program from 2019 to the present tells a different story.
The cost of providing Community Care services is higher than identical medical services provided at a VA facility. Many times, the OIG Report documented that the wait times may be longer for a Community Care appointment than from a VA facility.
The OIG should be commended for uncovering this problem before another $1.7 billion dollars is unnecessarily spent. We have to do better for both our disabled veterans and taxpayers!
John Plahovinsak is a retired 32-year Army veteran, who served from 1967 to 1999. He is the Disabled American Veterans (DAV) Department of Ohio’s Hospital Chairman and Adjutant of Chapter #63 (Clermont County. He can be contacted at: plahovinsak@msn.com.