October 4, 2019

Senators Cassidy, Hassan, Ernst, Sinema Raise Concerns Over VA Hiring Providers With History of Misconduct

WASHINGTON – Senators Bill Cassidy, M.D. (R-LA), Maggie Hassan (D-NH), Joni Ernst (R-IA), and Kyrsten Sinema (D-AZ) are calling on the Department of Veterans Affairs (VA) to take action following a troubling report from the Government Accountability Office that found Veterans Health Administration facilities are hiring providers with a history of misconduct.

“Veterans Health Administration (VHA) facilities lack adequate safeguards to ensure that veterans are not treated by providers who have a history of adverse actions against them related to providing substandard patient care, endangering public safety, substance misuse, or unprofessional conduct,” The Senators wrote. “We urge you to take immediate action to correct this issue and to ensure quality care for veterans who have sacrificed much in the brave defense of our freedoms.”

The Senators point to a disturbing and inconsistent adherence to policies related to verifying a potential provider’s credentials. This is due in part to a lack of uniform and mandatory credential training across facilities.   

The Senators continued, “In fact, the report details that staff responsible for the implementation of these credentialing standards were unaware of the standards in at least five facilities. Without uniform policies, appropriate training, and consistent implementation, VHA continues to hire providers that lack proper credentials to the detriment of veterans.”

The Senators are requesting detailed information from the VA about the steps it will take to address the problem.? 

Read the full letter below, or click here.  

Richard A. Stone, M.D.

Executive in Charge, Veterans Health Administration

U.S. Department of Veterans Affairs

810 Vermont Ave., NW

Washington, DC 20571

 

Dear Dr. Stone:

We write in response to a troubling report from the Government Accountability Office (GAO), which found that Veterans Health Administration (VHA) facilities lack adequate safeguards to ensure that veterans are not treated by providers who have a history of adverse actions against them related to providing substandard patient care, endangering public safety, substance misuse, or unprofessional conduct. We urge you to take immediate action to correct this issue and to ensure quality care for veterans who have sacrificed much in the brave defense of our freedoms.

The recent GAO report found that VHA lacks a properly designed and uniformly implemented provider credentialing system across the 18 Veterans Integrated Service Networks (VISNs). Although VHA officially requires the verification of credentials through the National Practitioner Data Bank (NPDB) before a practitioner can provide care to veterans, the report revealed disturbing lapses and inconsistencies in adherence to this policy. It is our understanding that this is due, in part, to the lack of mandatory training for credentialing personnel. In fact, the report details that staff responsible for the implementation of these credentialing standards were unaware of the standards in at least five facilities. Without uniform policies, appropriate training, and consistent implementation, VHA continues to hire providers that lack proper credentials to the detriment of veterans. 

As the leader of the VHA, you are responsible for ensuring that all providers are properly credentialed to provide veterans with the highest quality care. We appreciate VHA’s commitment to implementing annual credentialing trainings, as recommended by GAO, but there is still more to do. Therefore, we ask that you please respond to the following questions and document requests.

1.      By November 1, 2019, please outline the immediate steps VHA will take to ensure that medical personnel are adequately screened for proper credentials, including:

a.      The implementation of mandatory, periodic training on proper credentialing practices for credentialing personnel, chiefs of staff at VHA medical facilities, facility directors, and VISN directors;

b.      The implementation of VHA-wide standards on how to conduct credential screenings using the NPDB, and what “adverse actions” make a provider ineligible for VHA employment;

c.       The enrollment of all providers in “continuous query” of the NPDB, as well as periodic audits of the NPDB; and

d.      The transferability of eligibility determinations across facilities and VISNs using the VetPro system.

2.      By December 31, 2019, please provide a written report to Congress detailing:

a.      The content of the mandatory, annual training on proper credentialing practices;

b.      The number of VHA credentialing personnel who attended or will attend these trainings; and

c.       The VHA-wide standards for credentialing all providers and making eligibility determinations accessible system-wide.

Thank you for your attention to this important matter.

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