GAO Report VA Community Care Program VACCP

VA Exposed For ‘Cutting Corners’ When Picking Health Care Providers For Veterans, Again

A new report shows VA was caught referring veterans to ineligible healthcare providers with suspended or revoked medical licenses – two of whom had criminal records.

A government investigation showed many providers were ineligible to participate in the VA community care program. Ineligible providers are not supposed to be included in the referral system and are therefore unqualified for the role for some reason or another.

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But they were included, anyway. An estimated 1,600 ineligible providers were identified.

This problem of VA improperly using certain providers to give care to veterans is not new.

In 2019, VA was caught using unqualified doctors to treat veterans within his facilities. In 2015, VA was caught using unqualified doctors and nurses to diagnose traumatic brain injury.

Now, in 2022, this newly released report shows VA was using ineligible providers to treat veterans outside VA in the community care program – – little was learned from past failures, apparently.

What was going on?

GAO Community Care Provider Report

An investigation by the Government Accountability Office (GAO) found VA had improperly approved 1,600 physicians for referral in the community care program.

The community care program allows veterans to seek care in the community when challenges are experienced getting care within a VA facility.

RELATED: VA Not Reporting 90% Of Bad Doctors Or Other Healthcare Workers

The Veterans Health Administration (VHA) is responsible to oversight of the program formally known at the VA Community Care Program (VACCP). The VACCP program falls under the Office of Community Care. That office maintains a database created by contractors that is supposed to include only eligible healthcare providers.

But, as the report showed, at least 1,600 providers in the database are ineligible. They are ineligible in many instances due to revoked or suspended licenses. In a few instances, the provider had been accused of patient abuse, fraud, or other crimes that preclude participation. A large number of the ineligible were deceased.

One provider was found to be previously convicted of patient abuse and neglect with an expired medical license. The provider was previously arrested for assault and excluded from other federal healthcare programs.

Another provider previously posed a “clear and immediate danger to public health and safety.” That physician’s medical license was revoked.

RELATED: Veteran Psychiatric Care Neglected For Years

The report, published by Government Accountability Office (GAO), showed VA was “cutting corners” when approving providers who are legally ineligible to get paid under the VA community care program.

“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.”

From GAO Report

GAO provided the following summary in italics:

Of over 800,000 providers assessed, GAO identified approximately 1,600 VCCP providers who were deceased, were ineligible to work with the federal government, or had revoked or suspended medical licenses. VHA and its contractors had controls in place to identify such providers. However, the existing controls missed some providers who could have been identified with enhanced controls and more consistent implementation of standard operating procedures. For example, GAO found the following:

One provider had an expired nursing license in April 2016 and was arrested for assault in October 2018. This provider was excluded from working in federally funded health care programs. The provider was convicted of patient abuse and neglect in July 2019. The provider entered the VCCP in November 2019. VHA officials stated that this provider was uploaded into the system in error.

One provider was eligible for referrals in the VHA system, but his medical license had been revoked in 2019. Licensing documents stated that the provider posed a clear and immediate danger to public health and safety.

GAO also identified weaknesses in oversight of provider address data. Some VCCP providers used commercial mail receiving addresses as their only service address. Such addresses have been disguised as business addresses in the past by individuals intending to commit fraud. VHA has not assessed the fraud risk that invalid address data pose to the program.

These vulnerabilities potentially put veterans at risk of receiving care from unqualified providers. Additionally, VHA is at risk of fraudulent activity, as some of the providers GAO identified had previous convictions of health-care fraud. VA has an opportunity to address these limitations as it continues to refine the controls, policies, and procedures for this 2-year old program.

Lawmaker Seek Community Care Accountability

Lawmakers in the House Committee on Veterans Affairs sent a letter to the current acting head of VHA a strongly worded letter about the investigation’s findings:

The GAO report found that VHA and the third-party administrators responsible for developing and managing its Community Care Network failed to perform adequate and complete checks using several exclusionary data sources, as required by federal statute and the VHA Office of Community Care’s own standard operating procedures. As a result, GAO identified examples of healthcare providers remaining active in the Community Care Network, and therefore able to receive VA patient referrals, despite strong evidence of ineligibility. This included ineligibility based on previous healthcare fraud convictions, loss of medical licenses, and instances where providers appeared on the Social Security Administration’s Death Master File (i.e., were deceased).

The letter was addressed to Steven Lieberman, MD, the Deputy to the Under Secretary for Health performing the Delegable Duties of the Under Secretary of Health.

Boy, that is a mouthful of a title. Why is that?

Word Soup Titles Without Senate-Confirmed Leadership

Lieberman is the deputy to the Under Secretary for Health. But there is no Senate-confirmed Under Secretary for Health.

Lieberman is also performing the delegable duties of the Under Secretary for Health and apparently his own duties, somehow.

The VHA has lacked a Senate-confirmed Under Secretary for Health since the prior confirmed Under Secretary, David Shulkin, MD, was selected to serve as the Secretary for Veterans Affairs.

Dr. Shulkin was the last person confirmed into that role. Since then, the position has been vacant. We instead saw a word soup of titles used by the White House to explain the role of the decisionmaker in charge of Veterans Health Administration.

Some might say the lack of a confirmed head of the health agency is used as a device to limit political oversight.

But to what end?

Lieberman is not the only senior VA official to hold a similar title.

The Veterans Benefits Administration (VBA) also lacks a Senate-confirmed Under Secretary for Benefits.

The top spot is presently maintained by an official who previously held the acting role under President Barack Obama.

Thomas Murphy, Director of the Northeast District, is presently using the title Performing the Delegable Duties of the Under Secretary for Benefits to lead VBA. In 2016, Murphy did not receive the political support needed for a nomination to the top slot.

But, Murphy is now back in that same position after a long break from VA Central Office operations running various field offices.

It is unclear how long Secretary of Veterans Affairs Denis McDonough will tolerate no Senate-confirmed head of these agencies. With the White House and majority in the Senate and House, the lack of political leadership in either role is puzzling.

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  1. How disgusting. Everyone thinks veterans get optimal care that’s above what civilians get, I tell people every chance I get how bad it is. I’m not surprised of all this, just highly disappointed that this is what we get after putting our lives on the line for our country. I had to pay out-of-pocket for a spinal surgery the VA couldn’t even do, and I AM SERVICE CONNECTED for the spinal issue! Then the VA told me (including Patient Advocacy & multiple others at the VA) that I’m “On my own” because I went on my own and paid for a surgery the VA denied me for….again, I am service-connected for this. No one wants to help us. This is a sick system.

  2. With regards to VHA Directives, The VA looks great on paper. the directives cite Title 38 which cover Veterans healthcare. VHA directives are Federal law as mandated by Title 38.

    There are VHA Directives for just about everything just google it. The problems at the Roseburg VA in Oregon are that they don’t follow the Directives aka Federal Law. Use these directives to your advantage if you can.

    With regards to one Doctor named Thomas Lieb in Missouri, he was a rehabilitation/pain specialist who was caught running an opioid pill mill. now he is traveling VA C&P evaluator woking for VES performing C&P exams. I was evaluated by this so called Doctor.

    The problems with the unqualified VA doctors and Directors continues at the Roseburg VA in Oregon. The past director Doug Paxton made national headlines for retaliation against whistle blowers. Dave Whitmer was brought in to fix the broken Roseburg VA but shortly after he left Roseburg and became a Director in Georgia he resigned after being disciplined twice for whistleblower retaliation while he was at Roseburg amid charges he falsified testimony in an EEOC case.

    Now we have Director Keith Allen, whose qualifications for being a VA director are that he was a truck driver for the Postal Service before taking some college classes in electrical engineering and becoming a glorified electrician for the VA.

    Zero experience Allen is infamous for not following VHA Directives and The Patient Advocates per Roseburg’s office of Community care, “work for the Director”. these Patient advocates who should know all about VHA Directives are his right hand for ignoring them and denying Veterans Health Care, Medical Screenings, physical/Aqua therapy etc.

    I met with Allen three times at his request and Whitmer 5 of 6 times at his request to address the problems I and other Veterans have experienced getting healthcare through the Roseburg VA health care System.

    VA Directors are like a game of whackamole. Another unqualified Director pops his head up after the last one leaves.

    1. The motto is deny and they die. Over 85% gulf war veterans denied compensation and pension. Avg age of Vietnam veteran 73yrs old, but if your a career government cronie, hang around long enough, kneel before someone and you get promoted. I personally know of civilian registered nurses who are veterans who were denied employment at the Denver VA which opened at 50% strength yrs ago under pressure for delays and over cost, the nurses were told they didn’t fill out the paperwork correct. Or be held in the mental health inpatient ward where they put drugs, alcohol, physchiactric needs, homeless all together in a horseshoe shaped ward, again what a disgrace to the largest hospital system. Heck in the northeast they rented vans, told veterans to meet in shopping center parking lots and got vaccinated. Talk about taking care of veterans. But the president picked a long time friend, who isn’t a veteran, making hundreds of thousands of dollars so he can get his 30yrs in for a lifetime pension, the good ole boys at work

    2. The motto is deny and they die. Over 85% gulf war veterans denied compensation and pension. Avg age of Vietnam veteran 73yrs old, but if your a career government cronie, hang around long enough, kneel before someone and you get promoted. I personally know of civilian registered nurses who are veterans who were denied employment at the Denver VA which opened at 50% strength yrs ago under pressure for delays and over cost, the nurses were told they didn’t fill out the paperwork correct. Or be held in the mental health inpatient ward where they put drugs, alcohol, physchiactric needs, homeless all together in a horseshoe shaped ward, loagain what a disgrace to the largest hospital system. Heck in the northeast they rented vans, told veterans to meet in shopping center parking lots and got vaccinated. Talk about taking care of veterans. But the president picked a long time friend, who isn’t a veteran, making hundreds of thousands of dollars so he can get his 30yrs in for a lifetime pension, the good ole boys at work

  3. The Glass is Half-Full
    The more I learn the more I realize I don’t know as much as I thought. Actually 1,600 out of 800,000 is .002 percent. Which means 99.998% ARE qualified. There does need to be some established leadership going forward and improvements in wait times.

    I’ve had some really great treatment at the VA, but I’ve also experienced some really terrible things too. Complaining about them got me nowhere and was a waste of my energy. Network with other veterans, often they are the best source for solutions.

    My only frustration is long wait times, but I try to remember they are doing the best they can. Yes, it could be improved. but in a way, the VA has never been better. Older veterans are wise and know this truth.
    My question to you all is this: will the VA ever be ‘good enough’?

    1. There are some great people working within the VA system, but if you said they are on a 8hr shift, 3 hrs will be used with personal time, lunch, breaks, texts messages, shopping on government time, fraud, waste and abuse. The VA is the largest healthcare system in our country. Each VA works differently, there are all supposed to be on the same sheet of music. Why do the little VA’s built back in WW2 receive 4/5 stars and a 2.5 billion dollar Denver VA, 1 billion over budget, knowone went to jail, receives 2 stars. It’s about quality of care, not that the facility looks pretty

  4. I was an original VA whistleblower!
    I battled those a-holes for years…examples…..chief of food area was stealing thousands of dollars cash, out of the safe, which she left open. When long time employees reported it…they were immediately FIRED, and blackballed.
    Surgeons sleeping OUTSIDE the OR on chairs bcuz they worked all nite at their regular hospital….staff, interns performed surgery, many veterans died….all employees are threatened constantly. I was told to lie to vets, saying the surgery they needed cant be done….I demanded to know why — flat out from the Directors office “the less money they’d spend, the more $$$ upper management got in bonuses!!!” The Director was caught stealing at a different VA location…spent vets money to buy cars, houses etc…he got caught, they slapped his wrists and sent him to the VA I was at.. the Chief of Police found out what he’d done, and constantly blackmailed him.
    If they didnt like you, they’d send the VA police to follow you….OUTSIDE OF WORK!! 24 hours a day, taking pictures of you and who you were with.
    At one point the Chief of HR and his cronies, were secretly trying to write up an insane plan (I STILL have a copy of it)…NO employee could talk to veterans, other than the specific purpose of visit. If a vet got on an elevator, you had to get OFF. If you were out to dinner, and another employee saw you and they recognized a veteran also in the restaurant, you were REQUIRED TO LEAVE!! that employee who saw you and this veteran in the restaurant (not together), they can call management and report you, at which time you will be fired. They were NOT going to tell employees, just use it against us!! There are a zillion things I can tell all of you, it would take days and days. Senator Hellar investigated the VA, and when he turned in this 487 page report, he said ” this is only a small portion of what’s bad about the VA, but it should give you a strong reason to fix it!! I urge veterans to take back your VA. Put so much pressure on those a-holes, and send them ALL to jail forever.

  5. So Community Care. I called them because I hadn’t received any information about the referrals put in by the VA Drs. I received an email from community care stating the VA Drs put the referrals in incomplete. I asked did community care notify the Drs of their errors. They said it wasn’t their job. One mistake was as easy as crossing t and doting an I, but instead of doing that, community care sent it back denied. So if I wouldn’t have called, the bad referral would be sitting in cyber space.

    1. They ONLY want people who are willing to be robots…do what they are told. There ARE some good employees who stay under the radar, and will help. We all networked together, quietly, to get things done.
      Otherwise, you’d get kicked to the curb.

  6. Why don’t we try electing a Republican or Democrat again and see if anything different happens.

  7. What the OIG should look at is the Doctors inside the VA. A large percentage of them posed a clear and immediate danger to the veteran health and safety.

  8. I live in Canada and it’s hard to get to Togus VA in Main but to Covid restrictions. I was evaluated for tinnitus and severe hearing loss in my left and right ear.. I was evaluated by a VA approved doctor in New Brunswick who gave me a hearing test and needed hearing aids..I am 100% disabled and was told I could receive the aids through the VA.. Not being able to get to Togus I bought hearing aids..and was told I could be reimbursed..I submitted all the paperwork needed but to this day have not even received a letter stating if I was approved or denied, that’s been over a year ago…

  9. My experience at the cheyenne vamc is the primary care doctor not putting his foot down and demanding that I be referred to the community for a deadly blood disorder which was grossly mishandled by the very same clinic for 25 years.

    Mission Act clearly covers the ‘forced’ referral.

    ““(E) <> the covered veteran and the
    covered veteran’s referring clinician agree that furnishing care
    and services through a non-Department entity or provider would
    be in the best medical interest of the covered veteran based
    upon criteria developed by the Secretary. ”

    The ‘chief of staff’ COS and the supposed hematologist I was under the care of inside said va blocked the referral . . . for years.

    My last visit with the fraudulent hematologist, dr. ham, who claimed to be “doing this for over 20 years” did not know what Erythrocytosis was nor cared just how deadly it really is.

    I suggested to her that she prescribe 2 weeks of medical oxygen and then retest the Erythropoietin hormone to see if that calms it down. If not then the cyst on my kidney (caused by a 7 and 1/2 hour operation while active duty to save my life) is causing it so I would need a referral to a ‘credible’ Nephrologist. She is required to refer immediately if she discovers the cause. She refuses to do the ‘troubleshooting’ to find the cause and refused to refer.

    I finally convinced the ‘witch’ (I’m being nice here by not using a “B”) to send me to a hematologist downtown. Whoa and behold, his hands are severely tied by the va system of evil monsters.

    BTW, my PCP delayed my care by referring me to a dermatologist to treat the horrible sores on my skin covering most of my body in patches so painful it is maddening. The rotten derma doc tried to milk the referral for as much as he possibly could. He did realize on the first visit when I referenced my blood disorder when he stated, “I can only apply the band-aid effect because you need to see a credible hematologist.” He did suggest a referral but the COS and dr ham rejected it.

    4 doctors to include the E.R. doc suggested it. So, MASSIVE CORRUPTION to kill/murder the patient!

    The Mission Act was written by Senator McCain so that the Veteran patients could get the ‘good quality care’ they needed in an expeditious manner.

    The latest is the fact that the va refuses to send my records to the downtown providers (I have 2 for specialist reasons). They also refuse to get the records from the referred providers to add to my va records as required. They are required to send those records before the first appointment. The new Mission Act lays that out clearly.

    The va fails at every turn.

    Nuf sed.

    1. Could be incompetence in your case, I suspect there is more to the story we’re not hearing. Also has a medical release form been submitted by the patient? No release, no going forward. Senator McCain was responsible for the Choice Act, not the MA. Perhaps this VA patient needs to speak to a VA Care Coordinator.

      1. No medical record (you left that important word out) release form required because it is written in the ‘contract for community care’ that the records must be sent regardless of patient ‘open records’ release. The blanket release is so that anyone can look at your records and don’t need a reason to look at them. A trump era fiasco. trump wanted his billionaire friends to have full access to Veteran patient records so they could be manipulated by said billionaires.

        As for your remark that McCain didn’t write the Mission Act:
        June 6, 2018
        [S. 2372]
        John S. McCain
        III, Daniel K.
        Akaka, and
        Samuel R.
        Johnson VA
        Internal Systems
        Networks Act
        of 2018. 38 USC 101 note.

        His name is at the top because he wrote it and was in charge of seeing it through.

        Here is a tidbit for ya . . . trump refused to sign it for 6 months. Why? Because McCain wrote it and because trump hated McCain. So there.

        Did you look up Erythrocytosis? Erythropoiesis is the physiological process it is related to.

        The patient advocates at said location are corrupt as hell and do not properly log complaints as required by VHA Directive 1003.04 February 7, 2018 VHA Patient Advocacy

        “q. Report of Contact. A patient advocate or service level advocate must enter a Report of Contact (ROC) in the patient advocate tracking system that consists of all contacts that have an issue to be solved. ROCs need to be resolved and closed within 7 business days.”

        So, what cha think?

  10. Does anyone have the va email address for Thomas Murphy or the Under Secretary for Benefits. Yesterday I sent an email to an alphabet soup of VA bureaucrats who have been avoiding my 6/25/2020 criminal complaint about the falsification of missed appointments in VBA Rating Decisions. Anyone else see this as well?

    1. Let me enlighten you….
      I know first hand, that the Directors and management staff of the Regional offices (where you get your disability ratings) are given strict orders to NEVER to give an inch on your original submission. They automatically tell you NO in order to buy themselves time to process the workload they are behind on.
      I managed to get a marine vet a job at the Regional office (city), and he made sure the claims were paid correctly the first time. He was spending a ton of money, and they told him to STOP!!! He refused, stating he was following ALL the laws, rules, regs of the VA and government.
      He got immediately removed from the job, and put far down in the basement in archives to file!!

  11. What NEW, just another way to put our Veterans at risk, even the C&P Doctors are at times abusive, but it’s been happening for years, but these Doctors who have been ineligible should be put on a BLACK LIST, and AVOID at all cost, the VA Administration be ASHAMED for allowing this to occur

    1. Thanks for keeping the care providers accountable. Now review the providers that do exams for compensation. Some are indifferent to minorities. Others after given these contracts treat veterans as tho they are still government issue and are there to collect money . I have a hearing impairement . I feel as tho some providers are frustrated they have to repeat themselves. Equals inferior treatment 🧹

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