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By: FEDweek StaffThe Department of Veterans Affairs failed to properly track that all health-care providers under its Veterans Community Care Program (VCCP) were licensed, GAO has said.
In a Feb. 1 report, GAO found that two VCCP contractors did not consistently follow VA guidelines for vetting healthcare providers – typically those that fill in gaps for VA coverage, for example in rural areas where extensive travel might be required to reach a VA facility.
By law, providers who have lost their state medical licenses cannot work for VA. Likewise, providers who had their licenses revoked or terminated because of concerns regarding poor quality of care are ineligible. The companies in question, Optum and TriWest, are under VA contract to establish networks under the VCCP.
“However, VA’s contracts with these contractors do not require the verification of providers’ history of license sanctions, including a revoked license, in all states during credentialing,” the GAO report stated. “Only one of the two contractors has a process that includes verifying providers’ licensure history in all states and neither has a sufficient process for continuously monitoring provider licenses.”
GAO has recommended that VA “assess the risk to veterans when former VA providers with quality concerns continue to provide VCCP care,” and that all contractors establish and follow credentialing and monitoring standards.
