The VA has been flagged -- again -- as a "High Risk" agency for its health care delivery and the way it contracts for goods and services, according to a new Government Accountability Office report.

"We keep finding the same problems over and over" going back years at the VA, Comptroller General of the United States and GAO head Gene Dodaro said in testimony on the report Wednesday before the House Committee on Oversight and Reform.

GAO publishes a “High Risk List” on a biennial basis to identify programs and operations especially vulnerability to “fraud, waste, abuse and mismanagement,” according to the organization. There are 35 entities on newly released 2019 list; VA acquisition management is a new addition for this year, although the 2017 report did identify VA health care as a high-risk area that needed attention.

"[The VA has] a huge budget" at the VA, Dodaro said Wednesday. The VA budget totaled about $200 billion for fiscal 2019.

"It's not been for a lack of resources that they haven't addressed these problems, in my opinion," he said.

On health care, a GAO report released Wednesday said the VA needs to do a better job of oversight on how veterans enroll, which is generally the first step veterans take to enter the system.

"Not all newly enrolled veterans have been able to access primary care within VA, while other veterans experienced wide variation in the amount of time they waited for primary and specialty care," the report said.

There were often major discrepancies in the wait times calculated by the Veterans Health Administration and the actual wait times experienced by the veteran, according to the findings.

"To address this issue, VA needs to ensure the reliability of its data on veterans wait times, and ensure that VA medical facilities are consistently implementing its scheduling policy," the report said.

In a separate report, the GAO said the Department of Veterans Affairs was working off outdated regulations and policies on acquisition and contracting for goods and services, and lacked an effective strategy for procuring medical supplies.

The VA "needs to improve its procurement processes and achieve cost savings by complying with applicable policy and regulation to obtain available discounts when procuring medical supplies," the report stated.

The VA has "some of the most entrenched management problems I've seen" among government agencies in its acquisition process, Dodaro said at the hearing, in response to questions from Rep. Mark Green, R-Tennessee.

"When they tried to launch purchasing agreements, they didn't involve the clinicians as much as they should have in deciding what to purchase," Dodaro said, adding that he was encouraged by VA Secretary Robert Wilkie's pledges to reform. "So they're revamping this and we'll see if they come up with a better approach."

The GAO report on problems with VA's policy on procuring goods and services echoed two scathing reports in 2017 and 2018 from the VA's Office of Inspector General about poor conditions at the Washington, D.C., VA Medical Center due to acquisition failures and poor management.

The shoddy oversight of the medical supply system at the Washington hospital led to shortages in operating rooms, the IG's reports said. At one point, according to the reports, the operating room at the hospital ran out of vascular patches to seal blood vessels and ultrasound probes used to map blood flow.

In addition, the hospital had to borrow bone material for knee replacement surgeries, and also ran out of tubes needed for kidney dialysis, forcing staff to go on emergency runs to a private-sector hospital to procure them, the report said.

In the 2018 report, VA Inspector General Michael Missal said that "failed leadership at multiple levels within VA put patients and assets at the DC VA Medical Center at unnecessary risk and resulted in a breakdown of core services."

"It created a climate of complacency that allowed these conditions to exist for years," Missal said.

Last April, the VA put out a release detailing initiatives and corrective actions to cut red tape and improve patient care in an effort to get off GAO's "High Risk" list.

Wilkie, then acting VA secretary, said at the time that "we are serious about doing business differently to improve veterans care and we are holding ourselves accountable to the nation's veterans and to American taxpayers who entrust them to our care."

The headline for the release stated: "VA Takes Decisive Actions to Move off GAO High-Risk List," but the GAO's latest reports said that problems persist.

-- Richard Sisk can be reached at Richard.Sisk@Military.com.