Department of Veterans Affairs officials were aware that false wait times were being reported in southwestern VA hospitals for two years before they were in the press earlier this year,
The Arizona Republic reports.
But administrators did nothing to stop the practice despite a national directive against it, the newspaper reported Sunday.
In 2012, an audit by the VA's Southwest Health Care Network found that VA hospitals in Arizona, New Mexico and western Texas used multiple methods to falsify patient wait times, a practice which earned bonuses for those in charge of the facilities for meeting performance goals.
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Employees of the Phoenix center received $10 million in bonuses over a three-year period, the Republic reported. The information was based on records obtained in a Freedom of Information Act request.
Director Sharon Helman and other officials at the Phoenix VA Health Care System have said they knew nothing of the practice until retired VA doctor Sam Foote's allegations were made public in April. But the newly obtained records show Helman was aware of the problem when she took her job in February 2012, just a month after the audit was issued outlining the problem
According to the Republic, Helman made on-time appointments her top priority under a "wildly important goal" program.
As late as December, Helman was claiming to those outside the system that wait times were not a problem. As the Inspector General's office was investigating a whistle-blower complaint against the Phoenix facility, Helman wrote to Sen. John McCain that a July 2013 audit by her compliance office "validated local data collection efforts regarding EWL (electronic wait list) and access were correct."
Helman was suspended last month, and Susan Bowers was forced to retire as director of the VA's Southwest regional health-care office. Emails between the two, as well as other officials, show they were aware of scheduling problems throughout 2013, the Republic reported.
The VA set a wait-time goal of 14 days for veterans seeking medical care, but they were forced to wait weeks and months while placed on secret lists kept on paper. Veterans were moved onto computerized lists once their appointments were within the 14-day goal period, creating an appearance that the goal was being met.
The VA has admitted that more than 20 veterans died while waiting to see their doctor.
CNN reported the number at 40.
The problem was seen nationwide for at least four years. Records obtained by the Republic show additional tactics used to hide the real wait times that were uncovered in the 2012 audit.
Some hospitals canceled large blocks of appointments and said that the patients had canceled the visits. Some recorded walk-in patients as having made appointments. Appointments were made without dates for a requested appointment so that a false date could later be added. Some recorded false dates that doctors saw patients.
The audit recommended changes in the system, and then-VA Undersecretary Robert Petzel held a conference call in which he urged officials "not to 'game' the system." Petzel was forced to resign in May.
Last week, Acting VA Secretary Sloan Gibson ordered monthly on-site inspections by VA medical center and health-care system directors of every facility under their jurisdiction. The Republic notes that similar orders were made following the 2012 audit, but did not succeed in stopping the practice.
Rep. Jeff Miller of Florida told the Republic the new information is "continued proof of how VA leaders looked the other way while bureaucrats lied, cheated and put the health of veterans they were supposed to be serving at risk."
Miller, who has spearheaded the House investigation into the scandal, urged Acting VA Secretary Sloan Gibson to get rid the department's "widespread corruption" by pulling it out by the roots immediately.
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