Lawmakers are demanding to know why the Department of Veterans Affairs has failed to fully respond to a House VA committee inquiry into how it screens consultants, including its interactions with one private contractor that also was an adviser to opioid drug makers. (Stars and Stripes)
WASHINGTON — Lawmakers are demanding to know why the Department of Veterans Affairs has failed to fully respond to a House VA committee inquiry into how it screens consultants, including its interactions with one private contractor that also was an adviser to opioid drug makers.
Rep. David Valadao, R-Calif., who sits on the House Appropriations Subcommittee on Military Construction, Veterans Affairs and Related Agencies, sent a letter to VA Secretary Denis McDonough that renewed questions about McKinsey and Co., a consultant that advised the VA at the same time it was helping drug makers market opioids as prescription painkillers.
The letter, sent March 12, accused VA Secretary Denis McDonough of failing to fully explain the interactions with McKinsey or the agency’s protocols for vetting contractors before signing contracts with them, even though lawmakers requested the information a year ago.
“The VA has yet to adequately assure Congress that it has the appropriate procedures in place to recognize and respond to potential conflicts of interest with contractors,” Valadao said.
McKinsey has been at the center of litigation over its role in pushing opioid drug prescription sales in the U.S. The company in November 2021 agreed to pay about $600 million to resolve lawsuits brought by state attorneys general for its role in helping drug manufacturers with marketing campaigns to boost sales of the addictive painkillers.
In December 2023, the company agreed to pay $78 million to settle a class action claim by U.S. health insurers that the company contributed to a global drug abuse crisis.
McKinsey did not admit wrongdoing in agreeing to the settlement and said it believed its past work was lawful.
“Given the immense societal damage caused by prescription opioids, it is unacceptable that any private entity involved in the proliferation of these medications had the ability to influence the VA in its medical treatments of American veterans,” Valadao wrote in his letter to the VA.
Valadao’s office has received information that the VA did not follow protocols for vetting two of four contracts with McKinsey from prior years, said Faith Mabry, communications director for the U.S. House of Representatives.
Although the House VA committee sent a letter in 2023 raising concerns, it has not received “sufficient responses, especially on the process the VA uses to ensure there is no conflict of interest when entering into contracts,” she said.
Valadao’s letter also was signed by Reps. John Carter, R-Texas, Ryan Zinke, R-Mont., and John Rutherford, R-Fla. — all members of the subcommittee on military construction and veterans affairs.
Valadao said that lawmakers have an interest in gaining more oversight of the review process that the VA uses before entering into contracts with consultants.
“Veterans need to be confident that the medical care they receive at the VA is actually what is best for them and their health — not what’s best for private contractors looking to increase profits,” Valadao said.
McKinsey’s history of conflicts involving government contracting extends to the Food and Drug Administration.
In 2022, Rep. Carolyn Maloney of New York, who chaired the House Committee on Oversight and Reform, released a report titled “McKinsey and Company’s Conflicts at the Heart of the Opioid Epidemic,” which examined how McKinsey consultants worked on FDA contracts while also working for opioid manufacturers, including Purdue Pharma.
Maloney, who served in office from 2013-2023, said that McKinsey did not disclose its conflict to the FDA, raising concerns about its “ability to provide objective advice” and comply with the terms of its government contract.
Terrence Hayes, the VA press secretary, said the agency does not have any “active direct contracts” with McKinsey, “however, they may be a subcontractor of one of our direct contracts with another company.”
The VA in previous years never awarded contracts to McKinsey for work that involved decision-making about “medication prescribing protocols,” and the “VA shares Congress’ concerns regarding McKinsey’s alleged role in exacerbating the opioid crisis,” he said.
The VA can exclude vendors from consideration for further government contracts if an investigation finds that it has violated the terms of its contract, Hayes said.
McKinsey consulted with Purdue Pharma, Johnson & Johnson, Endo International and Mallinckrodt Pharmaceuticals on sales strategies for marketing OxyContin and other opioids between 2010 and 2019, while it also worked with the VA on projects involving health care delivery, management and IT services.
Drug overdose deaths among military veterans taking opioids rose by more than 50% from 2010-2020, according to the National Institutes of Health.
More than a half-million veterans in 2012 were on long-term prescriptions for the drug, the VA reported. VA doctors prescribed opioids to about 875,000 veterans in 2012, the VA said.
McKinsey maintains that it ended business consultations related to opioid sales in 2019.
The VA increasingly relies on private contractors to provide a wide range of services, according to the Government Accountability Office.
The VA paid $42.7 billion in fiscal year 2022 on all government service contracts, up from $18.2 billion in 2018, according to the GAO.
But a GAO report in January found the VA’s data for tracking service contracts was “unreliable and incomplete.”
The report warned that without better controls the VA is vulnerable to contractors inappropriately influencing the federal government’s “authority, control and accountability” over decisions.
