Record-keeping at some military hospitals is so bad that millions of dollars in insurance payments are being lost and hundreds of patients may be using the Social Security numbers of dead people to get free health care, congressional investigators say.
The General Accounting Office, in a review of military hospitals in Georgia, Virginia and Texas, said it also found potentially fraudulent uses of government credit cards and inadequate records of prescription drug inventories and usage.
"As a result of these control weaknesses, millions of dollars that could be used for patient care may be unnecessarily spent on ineligible patients, unused pharmaceuticals or unneeded purchases," the GAO said in a report released yesterday by Rep. Janice D. Schakowsky (D-Ill.).
Schakowsky and Rep. Dennis J. Kucinich (D-Ohio), asked the GAO to investigate financial controls at military hospitals after the Pentagon's $24 billion military health system overspent its budget in six of the past eight years.
"We must ensure that the Pentagon is held to the same level of scrutiny as other government agencies, especially when dealing with health care for our military personnel," Schakowsky said.
Kucinich called the GAO findings "another example of Congress throwing good money after bad for another Defense Department program that fails to pass even the most basic accounting standards and lacks sufficient oversight."
William Winkenwerder Jr., assistant secretary of defense for health affairs, concurred with the GAO findings and said the Pentagon is moving to correct the problems. He said new rules are being drafted to prevent the use of fraudulent military identification cards to obtain free health care and to hold hospital officials accountable for failure to collect insurance payments.
The GAO said it compared names, birth dates and Social Security numbers of patients at one unidentified military hospital to similar data in Social Security death records. The result: 41 patients who received care during fiscal 2001 were listed in Social Security records as having died before the year began.
Social Security numbers from another 225 patients also were found in the death records, but with differing birth dates or names. The GAO said those could have been the result of simple clerical errors or of individuals "fraudulently using a deceased person's identification to receive prescriptions and treatment at no cost."
While the GAO said its findings at three hospitals cannot be projected to the overall military health care system, the Pentagon inspector general estimated last year that 5 percent of the 8.4 million beneficiaries of Defense Department health care are either ineligible or have incorrect data in their records. The inspector general said the eligibility of another 10 percent could not be verified.
At all three hospitals studied, the GAO found that patients were not routinely asked to provide insurance information, and when such information was obtained, insurance companies often were not billed. Military hospitals legally can collect from insurance companies that cover patients who also are eligible for free military health care.
At Eisenhower Army Medical Center in Augusta, Ga., only 15 percent of patients reviewed had completed insurance information in their files, according to the GAO report. At the Naval Medical Center in Portsmouth, Va., such information was missing from a third of the files; at Wilford Hall Air Force Medical Center in San Antonio, it was missing from 41 percent of its files.
The Air Force Audit Agency estimated last year that the service's14 hospitals failed to collect $14.4 million from insurance companies during the previous six years.