Federal Reports

The Veterans Benefits Administration (VBA) provides a variety of benefits to eligible veterans, including monthly disability compensation or pension payments. VBA primarily relies on death notifications from the Social Security Administration (SSA) in an automated process called the death match to ensure that payments will properly stop when there is a record of a veteran’s death.The VA Office of Inspector General (OIG) conducted a limited evaluation of VBA’s processes for discontinuing compensation and pension benefit payments to deceased veterans to help improve VBA’s efficiency as well as prevent or redress fraud and waste. The OIG team reviewed three samples and determined that, in one sample, VBA was unaware its systems failed to complete one automated weekly death match in December 2020. The failed weekly death match resulted in payments continuing to 43 veterans after their deaths. Of those, 29 payments were made for seven months until those veterans’ deaths were discovered by the OIG.In a second sample, the review team determined the death match mechanism was limited because VBA’s electronic systems contained incorrect social security numbers, which may result in VBA continuing to pay compensation or pension benefits to veterans after their deaths. The team reviewed a judgmental sample of 140 veterans and found that 87 of the records had incorrect social security numbers in VBA’s electronic systems. In a third sample, the team reviewed a random sample of 121 veterans with dates of death between January 2017 and February 2021 and determined that VBA could have minimized improper compensation or pension payments to deceased veterans if it had obtained death notification data from the Veterans Health Administration. The OIG made three recommendations to improve oversight of and communication for VBA’s death match process that can help prevent improper benefit payments from being made to deceased veterans.

Nestor Rojas, a resident of Miami, pleaded guilty in U.S. District Court, Middle District of Florida, to one count of conspiracy to commit health care fraud and wire fraud on April 21, 2022. Our investigation found that Rojas conspired with others to unlawfully bill for approximately $1.4 billion of laboratory testing services which were medically unnecessary and fraudulently used rural hospitals as billing shells to submit claims for services that mostly were performed at outside laboratories. As a result of this scheme, Amtrak’s health care plans paid out more than $610,000 to three rural hospitals and associated laboratories. Rojas will be sentenced at a future date. Criminal judicial proceedings for additional co-conspirators are pending.

Dominique Henley, a former Amtrak baggageman based in Chicago, pleaded guilty to identity theft and was sentenced in the Circuit Court of Cook County, Illinois, on April 20, 2022, to 24 months’ probation. Our investigation found that Henley was in possession of 21 Social Security cards and 13 state and government-issued identification cards belonging to 21 different individuals. We found that of the 21 individuals’ identification documents in his possession, 19 were previously located in the Chicago Union Station lost and found or were reported lost on Amtrak trains. Henley was terminated from employment on November 3, 2020.