VA Secretary Dr. David Shulkin's chief of staff has resigned amid a scandal over travel expenses and allegations that records were altered to justify payments for Wimbledon tickets and Shulkin's wife's airfare.
In a statement Friday Afternoon, VA Press Secretary Curt Cashour confirmed Vivieca Wright Simpson's retirement and also said that the VA has opened a formal investigation of her actions as described in the IG's report, which also detailed "serious derelictions" on Shulkin's part.
Cashour also indicated that others at the VA could face discipline. "The VA will continue to review the IG report and its recommendations in more detail before determining possible additional personnel accountability actions," he said.
The retirement of Simpson, the No. 3 official at the VA, was first confirmed by Shulkin on Friday to USA Today, and came amid other turmoil at the VA over reports the White House is demanding faster expansion of the Choice program, which allows veterans to opt for private care.
A scathing report by VA Inspector General Michael Missal earlier this week charged that Wright Simpson doctored emails to Department of Veterans Affairs ethics officials to justify payment of the $4,132 airfare for Shulkin's wife, Dr. Merle Bari, on a trip last July to Denmark and London.
Shulkin and his wife also received a gift of tickets to the Wimbledon tennis tournament women's finals from a British veterans advocate, the IG's report said.
Shulkin told the House Veterans Affairs Committee on Thursday that he has agreed to reimburse the government for the airfare and the tickets, and he pledged to stay on at the VA.
"I am committed to continuing the work that I came here to do, which is to support the president's agenda to reform the VA and fix the VA the way that veterans deserve, the care and services they've earned," he told USA Today.
Shulkin faces another controversy over reports the White House is targeting the No. 2 official at the VA, Deputy Secretary Thomas Bowman, as a "warning shot" to Shulkin on the stalled efforts to reform and expand the Choice program.
The Washington Post quoted a White House official as saying the possible ouster of Bowman is "a move to knock Shulkin down a peg or two" over his perceived foot-dragging on Choice.
In a statement, Sen. Johnny Isakson, chairman of the Senate Veterans Affairs Committee, said he would be "deeply disappointed" in President Donald Trump if Bowman is being targeted.
"Tom Bowman is a veteran and a patriot, a public servant and a good man. If this is true, it will be a mistake, and I am deeply disappointed in the president," Isakson said. "Veterans will suffer because of this decision, if it's true."
Several Republicans and Democrats on the Veterans Affairs Committees of the House and Senate have urged that the IG's report be referred to the Justice Department for possible criminal investigation.
In another sign that his job could be in jeopardy, Shulkin was summoned to the White House Thursday to meet with Chief of Staff John Kelly, a retired Marine general whose own position has come into question in the uproar over spousal abuse allegations against former staff secretary Rob Porter.
There were no immediate indications from the White House or the VA that Shulkin might be on his way out, but the IG's allegations and the latest reports on the maneuvering to oust Bowman over the Choice program have left his status in doubt.
With the release of the IG report earlier this week, Rep. Mike Coffman, R-Colorado, a member of the House Veterans Affairs Committee, called for Shulkin's resignation, saying that the charges reflected a culture of corruption at the VA.
Shulkin was the only holdover from the Obama administration in the Trump cabinet and was far from Trump's first choice for the VA post to head the nation's largest health care system, serving more than nine million veterans annually at 170 hospitals and more than 1,000 outpatient sites.
Shulkin, who had been serving as the VA's undersecretary for Health since 2015, was chosen for the nomination days before Trump took office and only after several other potential nominees either dropped out or were rejected. He was unanimously confirmed by the Senate.
Since taking office, Shulkin has repeatedly been praised by Trump for turning around what the president saw as an inept VA bureaucracy that forced veterans onto wait lists for treatment and left their appeals for benefits backlogged in red tape.
However, there were early signs that Shulkin and Trump could eventually have a falling out over the administration of the Choice program.
During the campaign, Trump made the expansion of Choice part of his 10-point plan for reforming the VA, although the major veterans service organizations have consistently expressed concerns that overreliance on community care could ultimately lead to "privatization" of the VA.
Shulkin has sought to split the difference, stressing the VA's main mission as a health care agency while advocating for Choice where it's in the best interests of the veteran, particularly in rural communities where access to VA facilities is difficult.
The New York Times reported Thursday that Jake Leinenkugel, the senior White House adviser on veterans issues and a former brewery company executive, had sent an email to a Trump political appointee at the VA urging the ouster of both Bowman and Shulkin.
The email to Camilo Sandoval, a former Trump campaign official who now works at the VA, said that Shulkin should be replaced with a "strong political candidate," the Times reported.
In a highly charged statement Friday, Rep. Tim Walz, D-Minnesota, the ranking member of the House Veterans Affairs Committee (HVAC), said that the email was evidence that the conservative Koch brothers and other corporate interests were angling to privatize the VA.
"If President Trump truly puts the needs of veterans above all else, as we heard him say many times on the campaign trail, he needs to act immediately to distance his administration from forces who are using him as a pawn to achieve their long-standing goal of privatizing VA for their own financial gain," said Walz, a retired Army sergeant major.
In testimony Thursday before HVAC on the VA's budget for fiscal 2019, Shulkin said that about 36 percent of the veterans who sought treatment through the VA last year were served by private care.
The White House proposed a 2019 budget for the VA of $198.6 billion, an increase of $12 billion over 2018, and it included $14.2 billion for Choice in 2019 and $14.6 billion in advance appropriations for fiscal 2020.
The Veterans Choice Program was enacted in 2014 following a scandal concerning lengthy wait times for car at the Phoenix, Arizona, VA Medical Center, but it was set to expire in 2017. Congress has passed stopgap funding measures to keep the Choice program going but has yet to agree on a long-term fix for its management and mission.
At the hearing Thursday, Shulkin said there was enough money in the pipeline to continue Choice through the rest of this year while Congress and the VA work out reforms.
The initial Choice program allowed veterans who lived more than 40 miles from a VA facility or had to wait more than 30 days for an appointment to become eligible for private or community care.
-- Richard Sisk can be reached at Richard.Sisk@Military.com.