From the U.S. Government Accountability Office, www.gao.gov Transcript for: VHA's Credential Reviews Description: In this podcast we discuss how the Veterans Health Administration ensures their medical staff have the proper qualifications as they treat nearly 9 million veterans. Related GAO Work: GAO-19-6: Veterans Health Administration: Greater Focus on Credentialing Needed to Prevent Disqualified Providers from Delivering Patient Care Released: February 2019 [ Background Music ] [ Kathy Larin: ] There are nearly 9 million veterans who rely on the VHA for needed medical care. [ Matt Oldham: ] Welcome to GAO's Watchdog Report, your source for news and information from the U.S. Government Accountability Office. I'm Matt Oldham. The Veterans Health Administration provides services to nearly 9 million veterans at facilities across the country. And part of that job is making sure their healthcare providers, like physicians, dentists, or nurses have the necessary qualifications. I'm with Kathy Larin. She led a GAO report reviewing the VHA's efforts to ensure vets are being treated by qualified professionals. Thank you for joining me, Kathy. [ Kathy Larin: ] Thank you for having me. [ Matt Oldham: ] So, are vets who use VHA services seeing disqualified medical staff? [ Kathy Larin: ] So, we looked at a number of cases and we found that there were some instances where providers who did not meet the qualifications to work at a VHA facility were in fact providing care in that facility. In one case, for example, there was a provider who had surrendered his license due to an investigation of incompetence and gross negligence and was still hired by a VHA facility because he had a license in a different state that was valid. [ Matt Oldham: ] So, how does the VHA check if medical providers are qualified to provide care? [ Kathy Larin: ] The VA has staff -- credentialing staff, who look both at the qualifications of the providers to make sure that they have the qualifications, but they also look at whether a provider has been disciplined, either by another healthcare facility, or by a state licensing board. [ Background Music ] [ Matt Oldham: ] So, what role does licensing play in in the VHA's credentialing process? [ Kathy Larin: ] The credentialing process involves determining whether a healthcare provider has the education, the skills, the knowledge, the training in order to perform their duties at the facility. And the credentialers do have some latitude in looking at the individual facts and circumstances to determine on a case-by-case basis whether someone meets the qualifications. But one thing that is required is that they have a valid state license and that they not have a revoked or surrendered license for cause. [ Matt Oldham: ] When we're talking about disqualifying factors, we're not necessarily talking about medical care providers who are unlicensed, there could be other circumstances that would disqualify them. [ Kathy Larin: ] Exactly. I mean someone might have a valid state license in one state, but if they had a revoked or surrendered license in another state, they would be disqualified from working at the VHA. [ Matt Oldham: ] So, are there any challenges the VHA faces as they determine who is or who isn't qualified? [ Kathy Larin: ] Yeah, so the -- the VHA employees that are responsible for the credentialing process, what we found is that they don't always have a consistent understanding of VHA policies surrounding the disqualifying factors. And as a result, we found that there were some providers who had disqualifying factors who were still working at the VHA. [ Background Music ] [ Matt Oldham: ] So, it sounds like there have been some instances of the VHA using medical staff who should have been disqualified by VHA's own policies. Kathy, how can VHA improve this process? [ Kathy Larin: ] Well, we've made a couple of recommendations to the VHA. For one thing, VHA officials who are responsible for credentialing should be required to take training on VHA credentialing policies. And the VHA should be periodically reviewing all of its providers to ensure that they don't have any disqualifying factors. [ Matt Oldham: ] Lastly, what do you believe is the bottom line of this report? [ Kathy Larin: ] As you said, there are nearly 9 million veterans who rely on the VHA for needed medical care and it's critical that they be able to receive care from providers who meet VHA's qualifications. There's more that VHA can do to ensure that that's the case. [ Matt Oldham: ] Kathy Larin let a GAO report on VHA efforts to keep veterans from seeing disqualified medical staff. Thank you for your time, Kathy. [ Kathy Larin: ] Thank you. [ Background Music ] [ Matt Oldham: ] And thank you for listening to the Watchdog Report. To hear more podcasts, subscribe to us on Apple Podcasts. [ Background Music ] [ Matt Oldham: ] For more from the congressional watchdog, the U.S. Government Accountability Office, visit us as gao.gov.