The Gist
On September 30, VA handed Optum a 10-year contract worth up to $30 billion to run community dental care for veterans nationwide. Nineteen months earlier, VA’s own Inspector General estimated VA paid Optum about $783.4 million more for dental care than Optum paid the dentists, and paid TriWest about $127.3 million more. VA staff spotted the problem in 2021, and per the Inspector General, VA took no further action for 21 months. The fix finally shows up in the new contract. What doesn’t show up in VA’s award announcement, on the Inspector General’s report page, in its Senate testimony, or in VA’s 2025 financial report: any figure for money recovered.
Why this matters to veterans
About one in four enrolled veterans is eligible for VA dental care, and VA says more than 3.5 million dental procedures went through community care in fiscal 2025 alone. Every dollar paid to a middleman over what the dentist got is a dollar that didn’t buy a filling. Nothing here changes your dental benefits. It changes who’s watching the money.
If you work community care billing, at VA or at a contractor, or you’re a dentist in the network, I want to hear from you: ipersist@tbirdsquietfight.com.
Here is one dental claim, straight out of the Inspector General’s report.
Optum paid a community dentist $1,056.24.
Optum billed VA $2,024.13.
VA paid it.
The $967.89 in between stayed with Optum. That was on top of the fee VA already paid Optum to run the network.
The Inspector General didn’t say Optum broke the contract. That’s the problem. The contract let it happen.
Four contracts, one missing sentence
VA awarded its Community Care Network contracts starting at the end of 2018. Optum held Regions 1 through 3. TriWest held 4 and 5.
For most medical care, those contracts treat the administrator as a pass-through. Bill VA what you paid the provider. No more.
Dental was different. In four of the five regions, the Inspector General found, the contracts said only that VA would pay the administrator for dental care “at the rate negotiated and identified in the contract.” Not a word about what the dentist actually got paid.
So an administrator could pay a dentist less than the contract rate, bill VA the full rate, and, in the Inspector General’s words, “keep the difference.”
Region 5 was the exception. TriWest’s Region 5 contract had the pass-through language. VA had the fix in hand the whole time. It just wasn’t in the other four.
From fiscal 2020 through May 2024, the Inspector General estimated, VA paid Optum about $783.4 million more than Optum paid dentists. It paid TriWest about $127.3 million more. Together, $910.7 million: 37.3 percent of the roughly $2.4 billion VA spent on community dental care under those contracts.
Optum also collected about $42 million in fees for administering dental care from fiscal 2021 through 2023. The overpayment came on top of that.
VA’s own mistake, 66 percent at a time
Most of Optum’s share, about $648.7 million of the $783.4 million, traced to a VA contracting error. A paperwork mistake with a nine-figure price tag.
In March 2021, Optum sent VA a memo attaching VA’s own reasonable-charges dental schedule. VA’s contracting officers meant to add rates for new dental codes. They accepted the whole schedule instead, which raised the rates on codes already in the contract. On average, the Inspector General found, those rates ran about 66 percent higher than the ones VA had negotiated.
Cost of the mistake, June 2021 through May 2024: about $648.7 million. Region 3 alone: about $362 million.
VA’s contracting staff didn’t catch it. They “were not aware that the contracts’ existing contracted dental rates had increased before being informed by the OIG team.”
VA reset the rates in May 2023. In its February 2025 report, based on audit work through August 2024, the Inspector General wrote that Optum “continues to seek and be reimbursed at the increased rates.”
They knew in 2021
None of this snuck up on anyone.
In October 2021, according to VA meeting minutes the Inspector General reviewed, VA’s community care staff found the administrators had been paid about $46 million more than they paid dentists. They asked the contracting office what the contracts meant.
A contracting officer responded, the Inspector General reported, that dental services “were considered a pass-through across all five regions and an administrative modification was needed to update contracts 1-4.” The officer also recommended VA confirm how it meant dental to be paid. Discussions followed.
Then, per the Inspector General, VA’s Office of Integrated Veteran Care “did not take further action until July 2023.”
Twenty-one months. The overpayments kept running the whole time.
As of August 2024, VA was still negotiating the fix with each administrator.
“Explore”
The Inspector General published all of this on February 20, 2025, with seven recommendations. Two of them carry the story.
Recommendation 4 asked VA to make sure its community care office “considers” adding contract language capping dental payments at what the administrators pay providers. VA’s answer: it would “explore incorporating” the language, and “[i]f action is deemed necessary,” propose it.
Recommendation 6 asked VA to “explore potential recovery of dental payments to Optum.” VA said it would “partner with OALC to explore recovery” and support its acquisition office “as they continue to action recovery with Optum.”
Explore.
The Inspector General marked Recommendation 6 “closed” and “implemented” on November 26, 2025, and Recommendation 4 on May 6, 2026. What VA handed over to close them isn’t posted on the Inspector General’s report page.
Closed is not collected.
No recommendation asks VA to go after TriWest’s $127.3 million at all.
And one detail on the Inspector General’s own scorecard: the report page still lists $910.7 million as “Open.” The watchdog booked that money as “better use of funds” tied to Recommendations 4 and 5, and Recommendation 5, on VA’s controls over contract changes, isn’t closed. That’s an accounting label, not a bill. But by the watchdog’s own count, the job isn’t finished.
I went looking for the money
Not in VA’s announcement of the new contract.
Not on the Inspector General’s report page, or in its semiannual reports to Congress covering April 2025 through March 2026.
Not in the Inspector General’s February testimony to the Senate, which said the contracting error “has been corrected, and the corresponding VA OIG recommendation is closed.” It doesn’t say whether any money came back.
Not in VA’s fiscal 2025 financial report, either.
If VA has recovered a dollar of the $910.7 million, it hasn’t said so anywhere I can find.
Congress heard it in January
On January 22, the House Veterans’ Affairs Committee held its first hearing on CCN Next Generation, VA’s replacement for the community care contracts. Chairman Mike Bost (R-Ill.) said the contract “is going to cost the American taxpayer an estimated $1 trillion.”
On the second panel, Dr. Rachel Madley of the Center for Health and Democracy cited the Inspector General’s dental finding. She said the billing was “permitted due to a gap in contracts.” Rep. Maxine Dexter (D-Ore.) pressed it.
“As you cited in your testimony, there have been instances, for example, over $900 million in overpayments for dental services to Optum and TriWest,” Dexter said. “That appears to be a waste of taxpayer dollars in the community care program.”
VA’s witnesses had testified on the first panel. In the printed transcript, the dental overpayment never came up with them.
VA’s fiscal 2025 financial report tells the rest. The Inspector General’s section of that report, on VA’s management challenges, says missing pass-through language let administrators bill “VA for more than they paid dental providers, generating over $910 million in excess reimbursements.”
The same section describes the fix: “VHA is also inserting reimbursement caps and pass-through language into future Community Care Network contracts...”
Future contracts.
September 30
Then came the award.
On September 30, VA gave Optum Public Sector Solutions, which VA calls Optum Serve, a single contract to run community dental care nationwide for up to 10 years. Ceiling: $30 billion. Guaranteed minimum, per the solicitation: about $670 million. Three companies bid. Optum won.
Credit where it’s due. The solicitation’s terms close the hole. For standard dental claims, the contractor “shall ensure that the amount invoiced to VA is a direct pass-through and exactly matches the amount paid to the network providers.” Another clause: “There are no circumstances where VA payment for authorized services will exceed the provider’s billed charges.”
That language was in the solicitation from its first version in December 2025. VA did the work. Four years after its own contracting officer said dental was supposed to be a pass-through, but it did the work.
What VA didn’t do was mention any of this. The announcement says the contract will help VA “oversee and streamline community dental services.” Nothing about the $910.7 million. Nothing about the Inspector General. Nothing about the history of the company getting the keys.
Optum also holds one of the four new medical contracts VA signed on August 31.
What the new terms don’t settle
The fine print. The “exactly matches” sentence covers the main dental line. Two smaller kinds of claims don’t repeat that sentence: special higher rates in rural areas or where dentists are scarce, and procedures with no VA fee schedule rate. Both set the dentist’s pay and VA’s payment by the same formula. And VA can approve single-case agreements “with different rate.” Probably fine. Worth watching.
A ceiling that lasted three days. On March 20, VA amended the solicitation to cap those special rates at 200 percent above Medicare or the VA fee schedule. On March 23, it rescinded the change. The final solicitation set no percentage cap. Amendment 0013 gives no reason.
The old contracts. The Inspector General’s section of VA’s financial report pointed the fix at “future” contracts. The legacy contracts kept paying through fiscal 2026. VA has obligated more than $104 billion to Optum under its three regional contracts since 2018, for all community care, not just dental. Did VA ever add the dental fix to those contracts? Or did the gap stay open until the end? Nothing in the Inspector General’s reports, its testimony, or VA’s financial report says.
The other bidders. VA hasn’t named them in the award notice or the federal contract record. No protest showed on GAO’s docket as of October 5.
Still open
The $910.7 million. How much has VA recovered from Optum, and from TriWest? What did VA show the Inspector General to close the recovery recommendation?
The legacy contracts. Were Regions 1 through 4 ever modified to make dental a pass-through, and when?
The 200 percent cap. Why did VA pull it three days later?
The modification controls. Recommendation 5, on preventing the next contracting error, is still open nineteen months later.
Optum paid the dentist $1,056.24. VA paid Optum $2,024.13.
VA fixed the contract for the next ten years. It still hasn’t said what happened to the difference.
VA says Optum’s network is scheduled to be fully running within a year.
Make the Call
Two minutes. Offices track calls by issue, and staff notice when one issue keeps ringing.
Who to call:
Your own Representative and Senators. Find yours here.
Sen. Jerry Moran (R-KS), Chairman, Senate Veterans’ Affairs Committee: (202) 224-6521
Rep. Mike Bost (R-IL), Chairman, House Veterans’ Affairs Committee: (202) 225-5661
Capitol Switchboard, connects to any member: (202) 224-3121
Script 1: If you’re a veteran or military family member
“Hi, my name is [NAME], and I’m a [veteran / military family member] in [STATE]. I’m calling about VA’s new $30 billion community dental contract with Optum.
VA’s Inspector General estimated VA paid Optum and TriWest $910.7 million more for dental care than they paid dentists. VA hasn’t said publicly how much of that it got back.
I’m asking [MEMBER NAME] to make VA disclose what it has recovered from Optum and TriWest, and whether the old contracts were ever fixed.
Thank you.”
Script 2: If you’re a concerned citizen
“Hi, my name is [NAME], and I’m a constituent in [STATE]. VA just gave Optum a contract worth up to $30 billion to run veterans’ community dental care. VA’s own Inspector General estimated VA overpaid Optum and TriWest $910.7 million for dental care under the old contracts.
I’d like [MEMBER NAME] to ask VA one question in writing: how much of that money has been recovered?
Thank you for your time.”
Call first. Follow up with a personal email. A letter to your local paper reaches people the call doesn’t.
About This Publication
Tbird’s Quiet Fight is independent investigative journalism on VA policy, veteran benefits, and government accountability, published by the founder of HadIt.com, a veteran-run VA claims community since 1997.
Tips and sources: ipersist@tbirdsquietfight.com. If you worked on community care dental billing or the CCN contracts, at VA or at a contractor, I want to hear from you.
I use AI as a research and editing assistant, the same way I’d use a good reference book or a sharp editor. Every word published here is reviewed, verified, and approved by me. The perspective, accuracy, and editorial decisions are mine.
Last verified: October 5, 2026
Theresa “Tbird” Aldrich, Navy veteran (VAQ-34, 1983-1990), Investigative Journalist, TbirdsQuietFight.com, Founder of HadIt.com | Advisory Board Member, Veterans Healthcare Policy Institute (VHPI).
Sources
VA Office of Inspector General, Community Care Network Outpatient Claim Payments Mostly Followed Contract Rates and Timelines, but VA Overpaid for Dental Services, Report 23-00748-28 (Feb. 20, 2025) (PDF), pp. iv, 21-26, 41 (Appendix C), 44; recommendation status as shown Oct. 4, 2026
SAM.gov award notice, contract 36C10G26D0031, Optum Public Sector Solutions, Inc. (Sept. 30, 2026)
VA solicitation 36C10G26R0004, CCN Next Gen Dental Network: conformed copy (Mar. 27, 2026), Sections B.3, B.5.3-B.5.5, B.6; Amendments 0012 (Mar. 20, 2026) and 0013 (Mar. 23, 2026); Record of Questions, Amendment 0009, Q33
Federal Procurement Data System, record for 36C10G26D0031 (offers received: 3)
House Veterans’ Affairs Committee, Community Care Network Next Generation: One Trillion Dollars of Oversight, Serial No. 119-45 (Jan. 22, 2026), pp. 2, 50
VA, FY 2025 Agency Financial Report, pp. 124-125
USAspending.gov, CCN Region 1 (36C79119D0004), Region 2 (36C79119D0005), Region 3 (36C79119D0006), child award obligations (accessed Oct. 4, 2026)
Federal Procurement Data System, CCN Next Gen medical awards, solicitation 36C10G26R0003 (signed Aug. 31, 2026)
GAO bid protest docket, searched by solicitation 36C10G26R0004 (Oct. 5, 2026): no results