Dear Veterans’ Affairs New Zealand / New Zealand Defence Force,

Under the Official Information Act 1982, I request the following information concerning contracted, outsourced, or third-party administered health-related services for veterans, including but not limited to the administration of GP consultation reimbursements, pharmacy reimbursements, annual medical assessment processes, home independence services, treatment-card related claiming, and any associated provider-facing platforms or payment systems, for the period 1 January 2020 to the date of your response.

Please provide:
1. A list of all contracts, service agreements, memoranda of understanding, panel arrangements, procurement awards, or other formal arrangements under which external providers or entities have delivered, administered, reimbursed, processed, triaged, audited, or supported health-related services for Veterans’ Affairs clients.

For each arrangement, please include:
a. provider name
b. service description
c. commencement date and end date
d. procurement method used
e. total contract value or estimated value
f. responsible business unit
g. whether the arrangement replaced a previous provider or system.
2. Copies of the executed contracts, service specifications, schedules, statements of work, service descriptions, and KPI/performance schedules for:
a. Green Cross
b. ProCare
c. any other provider used for GP, pharmacy, treatment, rehabilitation, annual medical assessments, or reimbursement administration.
3. All procurement documents relating to the decision to change the provider for GP and prescription reimbursement administration from Green Cross to ProCare, including:
a. procurement plan
b. market analysis or market research
c. request for proposal or equivalent sourcing documents
d. evaluation criteria
e. moderation or scoring records
f. recommendation reports
g. approval papers
h. conflict of interest declarations
i. transition planning documents.
4. All performance monitoring material for each relevant provider from 2020 onward, including:
a. monthly, quarterly, or annual KPI reports
b. dashboards
c. audit reports
d. service reviews
e. contract management reports
f. performance breach notices
g. corrective action requests
h. correspondence concerning under-performance
i. meeting minutes where provider performance was discussed.
5. All documents that identify who within Veterans’ Affairs or NZDF is responsible for end-to-end oversight of these contracted or outsourced health-service arrangements after contract award, including:
a. governance structures
b. delegations
c. role descriptions
d. contract management frameworks
e. internal guidance
f. risk ownership documents.
6. Any internal reviews, lessons-learned reports, issue logs, briefings, or advice since 2020 relating to:
a. delays in provider payments or reimbursements
b. veterans being unable to access treatment because of provider claiming issues
c. transition risks when changing providers or systems
d. provider non-compliance with contractual requirements
e. data quality or reconciliation problems
f. rural access issues
g. complaints from veterans, GPs, pharmacies, or advocacy organisations about contracted health-service administration.
7. Any documents analysing whether current contracting or reimbursement arrangements align with commercial practice, value for money, veteran access needs, or administrative efficiency.
8. Statistics, by year where held, on:
a. number of claims or reimbursements processed through each provider
b. average processing times
c. declined, returned, queried, or unpaid claims
d. complaints received relating to provider-administered health reimbursements
e. number of providers enrolled in each system
f. any service disruption incidents.
9. Any internal audit, external audit, assurance review, or monitoring report since 2020 that assesses the effectiveness, efficiency, lawfulness, or data integrity of contracted or outsourced veterans’ health-service administration.
10. Copies of any briefings to the Minister for Veterans, Chief of Defence Force, Head of Veterans’ Affairs, or senior leadership relating to:
a. contracted health-service delivery
b. provider changes
c. service backlogs
d. oversight weaknesses
e. risks to veterans’ access to care.

If any part of this request is likely to be refused under section 18(f), please consider whether it can be refined or provided in stages under section 13, including by supplying a document schedule first.

Please provide the information electronically where possible.

Kind regards,
Spencer Jones