VA Billing Audit 2026: $1.9 Billion in Visits Missing From Billing-Review Reports, OIG Finds
By VA Headlines staff · Published Oct 30, 2026 · Source document dated October 26, 2026
About 985,000 VA patient visits valued at about $1.9 billion never showed up on the reports VA staff use to double-check whether care can be billed to private insurance, according to a VA Office of Inspector General (OIG) audit published October 26, 2026.
How VA billing is supposed to work
VA can bill veterans' private health insurance for care that is not related to a service-connected condition, and that money goes into the Medical Care Collections Fund (MCCF). According to the audit, MCCF collections were $3.8 billion in fiscal year 2024 and $4.6 billion in fiscal year 2025. When a visit is coded "reason not billable" (RNB), it is supposed to appear on a VistA RNB report so revenue staff can do a second-level review.
What the OIG found
The OIG found encounter data in VA's Corporate Data Warehouse that was not in VistA. About 12.6 million of the 23.5 million RNB-coded encounters in calendar year 2024 (53.8 percent) were not on the VistA RNB reports. For January through August 2025, it was 8.6 million of 15.3 million (57 percent). Because those encounters were missing from the reports, staff could not perform the required second-level review.
The OIG also found that revenue staff correctly identified an estimated 99 percent of nonbillable encounters for calendar year 2024.
What the money figure means
Based on VHA's input, the OIG calculated that VHA "could have collected up to $480 million" for encounters not captured by the reports, but only if those visits were for non-service-connected care, the services were billable, and the veterans had billable insurance. The OIG wrote that it "could not claim a reasonable monetary benefit for these encounters." The $1.9 billion is the value of the missing encounters, not money lost.
Recommendations
The OIG made three recommendations. The acting under secretary for health concurred with all three.
Why it matters
Money collected from insurers goes back into veterans' care. Gaps in the review process mean VA cannot be sure it is billing everything it should.
Related: VA painful scar rating errors review. How we report: Methodology & Corrections.
Audit of the Medical Care Collections Fund for VA-Provided Care
Report 25-00148-252 · October 26, 2026
Read the official document (PDF) · Report page
VA Headlines reports only what official records say. Spot an error? See our corrections policy.