VA Health Care: Action Needed to Improve Fertility Care Communications and Eligibility Determination Process

TL;DR

GAO found that the Veterans Health Administration (VHA) has gaps in communicating available fertility care and in its eligibility determination process after a policy change. From fiscal years 2022–2025 roughly 8 million veterans used VHA care, and veterans with an infertility diagnosis rose from about 19,000 in FY2022 to about 30,000 in FY2025. VHA’s Office of Women’s Health conducts outreach, but GAO found VHA has not implemented key performance practices to measure and target communication effectively, leaving some veterans unaware of services. VHA shifted eligibility decision authority to local VA medical center fertility teams in October 2024, and GAO identified inconsistent team composition, skill levels, and documentation of eligibility decisions. Immediate implications: increased demand and uneven eligibility decisions create near-term program risk and procurement opportunities for firms that can support communications, training, clinical staffing models, and compliance with HIPAA/FISMA-related controls. Contractors should assess capability to respond to follow-on work, prioritize HIPAA/FISMA readiness, and monitor solicitations and guidance from VA/VHA.

Key Points

• What happened: GAO reviewed VHA fertility care and found increased infertility diagnoses (FY2022–FY2025), shortcomings in outreach by the Office of Women’s Health, and problems after VHA moved eligibility decisions to facility-level fertility teams in October 2024.
• Who is affected: Healthcare and professional services market segments identified in segmentation, including NAICS 621111, 621112, 621399, 621410, 621491, 621498, 541611, 541612, 541990, and 611430; agencies: VA and VHA; contract vehicles listed in segmentation: VA FSS, T4NG, VECTOR.
• Timeline: Fiscal years 2022–2025 data frame; policy/process change implemented October 2024.
• What contractors should do NOW: validate HIPAA and FISMA controls, prepare staffing and training offerings for facility-level fertility teams, develop outreach and patient-communication proposals aligned to measured performance goals, and activate Cabrillo monitoring and capture workflows to detect VA follow-on solicitations.

Who Is Affected

• Specific NAICS codes, agencies, and contract vehicles pending source review.
• Market segments called out in segmentation: Healthcare Services, Medical Services, Reproductive Health, Women's Health, Healthcare IT, Healthcare Communications, Patient Outreach, Medical Training, Healthcare Consulting, Veterans Healthcare.
• Compliance surfaces listed in segmentation to prioritize: HIPAA, FISMA.

Frequently Asked Questions

Q: Why did infertility diagnoses increase between FY2022 and FY2025?

A: GAO reports the number of veterans with an infertility diagnosis rose from about 19,000 in FY2022 to about 30,000 in FY2025. VHA officials noted there may be several reasons for the increase, including expansions VHA made to eligibility for fertility care in 2024.

Q: What changed in eligibility determinations and when?

A: In October 2024 VHA changed the process so VA medical center fertility teams—not VHA nationally—are responsible for determining veterans’ eligibility for certain fertility care. GAO found variability in team composition, skills, and documentation practices after the change.

Q: What weaknesses did GAO identify in communications about fertility care?

A: GAO found VHA’s Office of Women’s Health uses a fertility webpage and brochures but has not implemented key performance practices for communications. GAO cited stakeholder concerns that some veterans—e.g., male veterans—may be unaware of services or find eligibility information difficult to locate.

Definitions

• Infertility: The inability to conceive or sustain a pregnancy (term and context provided in the GAO summary).
• VHA (Veterans Health Administration): The VHA is the entity within the Department of Veterans Affairs responsible for delivering health care to enrolled veterans (term appears in the summary).
• Office of Women’s Health: VHA office responsible for communicating available fertility care (term appears in the summary).
• In vitro fertilization: A type of fertility care referenced by GAO as an example of services for which eligibility may require a causal relation to a service-connected disability (term appears in the summary).

Intelligence Response

• Cabrillo Signals War Room — Already detected this event and delivered this briefing. Continuously monitors regulatory changes, contract vehicles, and policy shifts so capture teams receive immediate alerts when GAO reports or VA policy changes hit the stream.
• Cabrillo Signals Match Engine — Automatically rescored opportunity pipelines for clients whose services map to Healthcare Services, Medical Training, Healthcare Communications, and Healthcare IT when this event increased projected demand for fertility care support at facility level.
• Cabrillo Signals Intelligence Hub — Searched for follow-on solicitations and set saved searches for VA, VHA, and the contract vehicles listed in segmentation (VA FSS, T4NG, VECTOR). Alerts will trigger if relevant solicitations appear on SAM.gov (System for Award Management).
• Proposal Studio (Proposal OS) & Proposal Studio Workflow Tracker — Use Proposal OS to rapidly assemble compliance matrices (HIPAA/FISMA) and win themes for communications, training, and staffing proposals; use Workflow Tracker for 9-gate capture management and audit-ready documentation.

Who to notify:

• BD lead / Capture manager — to evaluate bid/no-bid and mobilize capture.
• Proposal manager — to start compliance and staffing narratives.
• Security & Compliance officer — to validate HIPAA/FISMA posture for healthcare engagements.
• Delivery lead / Clinical staffing lead — to scope team composition and training offerings.
• Communications lead — to draft performance-based outreach solutions.

First 48-hour response playbook

• Hour 0–4: Confirm receipt of GAO event in Cabrillo Signals War Room. Notify BD, capture, proposal, compliance, and delivery leads. Spin up initial capture folder in Proposal Studio.
• Hour 4–12: Run Match Engine rescoring for active VA/VHA opportunities; prioritize those that align to Healthcare Services, Medical Training, Healthcare Communications, and Healthcare IT. Begin HIPAA/FISMA gap checklist in Proposal OS.
• Hour 12–24: Assign responsibilities for developing capability statements: communications campaign with measurable KPIs, facility-level staffing/training plan, and eligibility decision-support tools. Start 9-gate Workflow Tracker sequencing.
• Hour 24–48: Draft outreach and staffing solution briefs, assemble compliance artifacts, and prepare to respond to any immediate RFI or draft solicitation. Activate Intelligence Hub saved-search alerts for VA FSS, T4NG, VECTOR solicitations and related VA/VHA notices.

Related reading and compliance resources:

• Winning Federal Contracts Guide (/insights/winning-federal-contracts)
• CMMC (Cybersecurity Maturity Model Certification) Compliance Guide (/insights/cmmc-compliance-guide)
• CUI (Controlled Unclassified Information)-Safe CRM Guide (/insights/cui-safe-crm-guide)