December 11, 2017
U.S. Sen. Jim Inhofe (R-Okla.) joined a bipartisan group of U.S. senators calling on the Department of Veterans Affairs (VA) to conduct a nationwide review of its providers after a USA Today investigation found multiple providers hired by the Department had at least one state medical license revoked due to malpractice.
In a letter to VA Secretary David Shulkin led by Sen. John Boozman (R-AR), the senators presented a series of questions.
“For years, states have experienced provider shortages across many different medical specialties, and like the private sector healthcare industry, the VA has faced similar provider shortages,” the senators wrote to Shulkin. “As such, we request information about the VA’s oversight of provider hiring guidelines to ensure that the pressure to fill shortages has not led to insufficient health care quality controls.”
In addition to Boozman and Inhofe, the letter was signed by Tammy Baldwin (D-WI), John Barrasso (R-WY), Bill Cassidy, MD (R-LA), Tammy Duckworth (D-IL), Dick Durbin (D-IL), Mike Enzi (R-WY), Orrin Hatch (R-UT), Jeff Merkley (D-OR), Jerry Moran (R-KS), Bill Nelson (D-FL), Chris Van Hollen (D-MD) and Ron Wyden (D-OR).
Full text of the letter can be found here and below:
December 8, 2017
The Honorable David Shulkin
U.S. Department of Veterans Affairs
810 Vermont Ave NW
Washington, DC 20420-0001
Dear Secretary Shulkin:
We write to express our serious concerns regarding recent media reports suggesting that the Department of Veterans Affairs offers employment to medical practitioners with a known history of licensure revocation by a state medical licensing board. The national reporting also highlighted cases of the VA hiring providers with known conduct and performance deficiencies that resulted in sanctions and criminal charges of the individuals.
For years, states have experienced provider shortages across many different medical specialties, and like the private sector healthcare industry, the VA has faced similar provider shortages. For states, such as Arkansas, in which many veterans eligible for VA care are rural, the provider shortage is even more pronounced. As such, we request information about the VA’s oversight of provider hiring guidelines to ensure that the pressure to fill shortages has not led to insufficient health care quality controls.
We request that the Department of Veterans Affairs conduct a nationwide review to identify all providers by state and specialty, who were known to have had adverse actions taken against their clinical privileges, to include the revocation of state medical licensure, and were subsequently hired by the Department. Of the individuals identified by the aforementioned report, what is the employment status of each individual identified? What additional oversight measures are required for providers identified through this review who remain employed by and practicing within the VA?
In addition to a review to determine the current status of providers within the VA, we would also like information relevant to oversight of VA policies regarding hiring of individuals who have disciplinary or performance deficiencies that resulted in sanctions, claims, or charges. At what level is a final personnel decision approved? Does the VA have regular reporting and review of any providers hired under these circumstances? How is the performance and conduct of such individuals tracked, including the healthcare outcomes they deliver for veterans? When the VA intends to hire a provider with known medical malpractice claims, what additional scrutiny or consideration are such applicants subjected to?
Does the VA have authority to hire a provider whose license has been revoked? When the VA considers hiring these providers, at what level does the VA approve a final offer of employment? Are such hiring decisions subject to reporting requirements to the Department? If so, to what level? Following the employment of such a provider, does the VA require any probationary periods of review or mandatory consultation prior to authorizing the direct provision of care to patients? Do these positions include any responsibility for the direct provision of medical care?
Please confirm the status of this request and provide a timeline for completion of the requested review. We ask that you please keep our offices updated on this issue. Thank you for your consideration of this request.