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VA vows changes on bad health care providers, lawmakers take action after investigation

By DONOVAN SLACK | USA Today | Published: October 12, 2017

WASHINGTON (Tribune News Service) — The Department of Veterans Affairs is pledging to overhaul its reporting policies for bad medical workers and a group of lawmakers is introducing legislation following a USA TODAY investigation that found the VA has routinely concealed shoddy care and staff mistakes.

VA Secretary David Shulkin directed agency officials to expand a nearly 30-year-old policy that limited what medical providers the agency would report to a national database created by Congress to prevent problem medical workers from crossing state lines to escape their pasts and keep practicing.

The agency will report all clinicians going forward, VA Press Secretary Curt Cashour said. Shulkin also asked staff to re-write 12-year-old guidelines for reporting them to state licensing boards in an effort to speed up the process.

"Under Secretary Shulkin, VA's new direction is to hold employees accountable and to be transparent with our findings and actions," Cashour said.

The legislation from Rep. Cathy McMorris Rogers, R-Wash., Rep. Phil Roe, R-Tenn., and Rep. Bruce Poliquin, R-Maine, would require VA doctors themselves to report directly to state licensing boards within five days of witnessing unacceptable behavior from fellow doctors.

"These newest reports out of the VA are deeply troubling," McMorris Rodgers said. "This bill will help reform the culture at the VA by holding bad actors accountable and keeping them from continuing these mistakes at the VA or elsewhere."

The USA TODAY investigation found the VA has frequently failed to ensure its hospitals reported problem health care providers to state licensing boards. Such reports can be delayed by years. The investigation also found the VA policy on reporting to the national database left out thousands of providers. The agency previously reported only physicians and dentists – no nurses, physicians' assistants, or podiatrists.

The VA determined one podiatrist at its hospital in Maine harmed 88 veterans, including a woman who after two failed ankle surgeries chose to have her leg amputated rather than endure the pain. Still, the agency didn't report the foot doctor to the database under its previous policy, and took two years to report him to state licensing boards.

In other cases, USA TODAY found VA hospitals signed secret settlement deals with dozens of doctors, nurses and other health care workers that included promises to conceal serious mistakes – from inappropriate relationships and breakdowns in supervision to dangerous medical errors – even after forcing them out of the VA.

Roe, chairman of the House Veterans Affairs Committee, said the committee has "long been concerned about VA's settlement agreements, and even held a hearing on the topic last year."

"The findings of the USA TODAY investigation are intolerable," he said. "Malfeasance within the department will not be ignored, and it certainly cannot be rewarded and hidden from state licensing boards. As a physician, I find this deeply troubling."

In response to USA TODAY's findings, Shulkin directed that any future settlement agreements worth more than $5,000 be approved by top VA officials in Washington. Previously, local and regional officials made decisions on the deals, which can cut short potentially costly employee challenges of VA disciplinary actions.

On Wednesday, the agency also said it planned to post publicly for the first time data on settlements that are approved. The first tranche of data shows that since President Trump took office in January, the VA has struck agreements with at least 160 employees involving payouts totaling $4.2 million.

Poliquin said Thursday that USA TODAY's findings were "appalling" and singled out the revelations about the podiatrist at the Togus VA hospital on the outskirts of Augusta, Maine.

"Our Maine veterans depend on their services at Togus and other VA facilities across our State for critical care, and it is absolutely unacceptable for them to ever be subjected to this kind of medical malpractice," he said.

At least six patients of the podiatrist, Thomas Franchini, are suing the federal government over the care they received. Despite the VA taking years to tell patients about its findings on his surgeries, the government has argued their claims should be dismissed because they were filed after the three-year deadline for medical negligence claims in Maine.  Oral arguments in the case are scheduled October 25.    

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Secretary of Veterans Affairs Dr. David Shulkin, at a Senate hearing in February, 2017.
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