More than half of sampled-era encounters were omitted
The VA inspector general found about 985,000 medical-care encounters valued at $1.9 billion missing from Veterans Health Information Systems and Technology Architecture revenue reports. The watchdog estimated up to $480 million in potential additional collections.
That potential equals 25.26% of the value of the omitted care. It should not be described as money already owed or certain to be collected because eligibility, insurance coverage and billing rules still apply.
| Measure | Result |
|---|---|
| Omitted encounters | About 985,000 |
| Value of care | $1.9 billion |
| Potential collections | Up to $480 million |
| Potential/value ratio | 25.26% |
The omission rate worsened
The report puts the missing-encounter rate at 53.8% in 2024 and 57% from January through August 2025—an increase of 3.2 percentage points.
That trend indicates the reporting control did not merely miss a fixed backlog. It continued to exclude a majority of relevant encounters during the later period reviewed.
Billing protects clinical resources
VA’s Medical Care Collections Fund recovers eligible costs from third-party insurers; it does not bill veterans for service-connected care in the same way. Missing encounters can therefore leave lawful insurer revenue unpursued.
The watchdog made three recommendations and VA concurred. Concurrence does not establish how much of the estimated opportunity will survive eligibility review or be collected.
Method and limits
This newsroom compared the two reported omission rates and divided potential collections by the value of flagged care. The encounter testing and revenue estimate belong to VA OIG.
The audit describes an upper-bound opportunity, not a receivable ledger. Actual collections depend on coverage, coding, timely filing and insurer adjudication.
Sources and further reading
VA OIG medical-care collections audit ↗
Marion VA hospital aerial photograph and public-domain record ↗