WASHINGTON — The Department of Veterans Affairs failed to thoroughly Vet medical providers for its community care program, resulting in doctors with revoked or suspended medical licenses being approved to treat Veterans, according to a new report from the Government Accountability Office.
The GAO investigated the VA’s community care program, which sends Veterans to private-sector doctors in certain situations. When Vetting doctors to allow them into the program, the VA was “cutting corners,” the investigation found. The GAO identified 1,600 providers who were ineligible for the program under the VA’s policies but had been accepted into it.
In some cases, the doctors had criminal records or had previously committed health-care fraud.
“Our work … basically found that they were really cutting corners,” said Seto Bagdoyan, director of audits at GAO. “They were not performing monthly checks, for example. And even when they did flag someone as ineligible, that individual… was not removed in a timely manner.”
In one instance, the VA approved a doctor who had been convicted of patient abuse and neglect. The doctor also had an expired medical license, had been arrested for assault and had been excluded from participating in other federal health-care programs.
Another doctor who was accepted into the program had a revoked medical license and posed a “clear and immediate danger to public health and safety,” the GAO reported.
“This individual was somehow deemed eligible for referrals in the program,” Bagdoyan said. “Both of these examples help illustrate that having ineligible providers poses a risk to Veterans’ health.”
The VA refers Veterans to community care in certain cases, including when they must wait longer than 20 days for an appointment or drive more than 30 minutes to reach their VA health-care provider. The program expanded under the VA Mission Act, a measure approved in 2018.
During its investigation, the GAO assessed 800,000 of the approximately 1.2 million providers involved in the community care program. Of the 800,000, the watchdog found 1,600, or 0.2%, shouldn’t have been approved.
The GAO recommended the VA follow its own regulations for community care doctors “without cutting corners.” It also suggested the VA improve its systems to automatically flag providers who don’t meet the criteria for the program.
The VA agreed to implement all the recommendations this year. Bagdoyan said the department was “eager” to review the providers flagged by the GAO.
After the GAO’s findings were released Thursday, four lawmakers on the House Committee on Veterans’ Affairs wrote to Steven Lieberman, deputy to the VA undersecretary for health, urging him to review and deactivate the 1,600 providers.
Reps. Chris Pappas, D-N.H., Tracey Mann, R-Kan., Julia Brownley, D-Calif., and Jack Bergman, R-Mich., signed the letter. They asked the VA to update them by Feb. 28 about the actions taken.
“This put Veterans at risk of receiving care from unqualified providers, and it put [the Veterans Health Administration] at risk of making payments to fraudulent providers,” the lawmakers wrote.
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