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Audit says more than 57,000 await first VA appointment

WASHINGTON — About 57,000 US military veterans have been waiting 90 days or more for their first VA medical appointments and an additional 64,000 appear to have fallen through the cracks, never getting appointments after enrolling and requesting them, the Veterans Affairs Department said Monday.

It’s not just a backlog problem, the wide-ranging review indicated. Thirteen percent of schedulers in the facility-by-facility report on 731 hospitals and outpatient clinics reported being told by supervisors to falsify appointment schedules to make patient waits appear shorter.

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The audit is the first nationwide look at the VA network in the uproar that began with reports two months ago of patients dying while awaiting appointments and of coverups at the Phoenix VA center.

A preliminary review last month found that long patient waits and falsified records were ‘‘systemic’’ throughout the VA medical network, the nation’s largest single health care provider, which serves nearly 9 million veterans.

‘‘This behavior runs counter to our core values,’’ the report said. ‘‘The overarching environment and culture that allowed this state of practice to take root must be confronted head-on.’’

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Richard Griffin, the VA’s acting inspector general, said his office was investigating 69 VA medical facilities nationwide for possible wrongdoing, up from 42 two weeks ago. The investigations could result in criminal charges, which Griffin said may be needed to neutralize senior VA leaders who have allowed and even encouraged fraudulent scheduling practices often referred to as ‘‘gaming’’ the system.

‘‘Once someone loses his job or gets criminally charged for doing this, it will no longer be a game. And that will be the shot heard around the system,’’ Griffin said Monday night at a hearing of the House Veterans Affairs Committee.

Acting VA Secretary Sloan Gibson said earlier that officials have contacted 50,000 veterans across the country to get them off waiting lists and into clinics and are in the process of contacting 40,000 more. Gibson said the VA is hiring workers at overburdened health care facilities.

In Massachusetts VA hospitals and clinics, the audit said, fewer than 600 patients are waiting for initial medical appointments 90 days or more after requesting them. Of the 64,000 patients who enrolled in the VA health care system nationwide over the past 10 years who have never had appointments, fewer than 900 sought treatment in Massachusetts.

While Massachusetts fared better than many other states, one negative statistic stood out. The VA’s Central Western Massachusetts Healthcare System had one of the top 10 longest wait times — 67 days — for new patients trying to see a specialist.

The national controversy forced VA Secretary Eric Shinseki to resign May 30. Shinseki took the blame for what he decried as a ‘‘lack of integrity’’ through the network.

Legislation is being written in both the House and Senate to allow more veterans, including those enrolled in Medicare or the military’s Tricare program, to get treatment from outside providers if they can’t get timely VA appointments. The proposals also would make it easier to fire senior VA regional officials and hospital administrators.

House Speaker John Boehner said the report demonstrated that Congress must act immediately. ‘‘The fact that more than 57,000 veterans are still waiting for their first doctor appointment from the VA is a national disgrace,’’ said Boehner.

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