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Executive Summary

The Veterans Affairs Canada Health Care Benefits Program provides eligible Veterans and other qualified individuals with benefits and services, such as medical, surgical and dental care, prosthetic devices and home adaptations, through 14 Programs of Choice. Under the Veterans Health Care Regulations and Canadian Forces Members and Veterans Re-establishment and Compensation Act, eligible Veterans and other qualified individuals have access to benefits and services, such as medical, surgical and dental care, prosthetic devices and home adaptations. Related Health Services are services provided by health care professionals other than physicians, dentists and nurses. Examples of these types of services include occupational therapy, physiotherapy, massage therapy, chiropractic, acupuncture, speech language pathology and psychological counseling.

The objective of this audit was to assess Veterans Affairs Canada’s management control framework, and compliance with applicable policies and processes, and to identify any potential opportunities to improve efficiency of decision making for Related Health Services. The scope covered transactions processed from April 1, 2012 to March 31, 2013.

The audit team observed that the relevant policies and procedures were generally clear and up-to-date with only a few areas noted requiring further action. It was also noted that key monitoring activities such as quality assurance, performance measurement and post payment verification were in development. File review results identified a moderate degree of compliance with key requirements and that staff carry out their duties efficiently and exercise appropriate judgment to process requests as quickly as possible. Overall, the audit team determined the results to be "Generally Acceptable".

Chief Audit Executive's Signature

Kim Andrews
Acting Chief Audit Executive

Date: October 9, 2014

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