Synergy - September/October 2012 - 22

namss focus

Veterans Affairs MSPs

Are a Lot Like You

state, commonwealth, territory or the District of Columbia. This allows for the mobility of the work force. It is good practice to verify all current and previously held licenses; VA policy requires it. An additional requirement is placed on licensure in that for any license that has been revoked or surrendered after notification of potential for revocation, the provider may not work for VA until the license is fully reinstated with no limitation on practice regardless of the status of other licenses. Education and Training: VA medical centers complete the verifications of education and training in accordance with TJC accreditation standards. In defining the verification process in policy, a “good faith effort” is defined as two attempts to verify the credential, separated by no fewer than 15 days for requests made in the continental United States and 30 days for other locations elapse before the attempt is deemed unsuccessful.

By Kathryn W. Enchelmayer, CPCS, CPMSM, MHSA

magine your board of directors is Congress and your catchment area could serve more than 22 million people with more than 8.5 million enrollees. This is the Department of Veterans Affairs (VA), Veterans Health Administration (VHA). We at VA take our responsibility to the care of our nation’s veterans seriously. Our mission dates back to Abraham Lincoln, who said “To care for him who shall have borne the battle, and his widow and orphan.” We fulfill our mission by administering the laws and providing benefits and services to veterans and their dependents. The VHA is the healthcare arm of the agency. VHA has four core goals/ objectives: 1. Deliver healthcare 2. Provide health professional training 3. Perform research 4. Practice emergency preparedness (including backup to the Department of Defense and the National Disaster Medical System) To deliver this care, VA utilizes approximately 56,000 licensed independent practitioners (LIP), of whom approximately 35,000 are physicians in 152 VA medical centers, 807 outpatient clinics, as well as Vet Centers,
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community living centers and residential rehabilitation treatment programs. VA medical centers are accredited by The Joint Commission (TJC), as well as specific programs accredited by the Commission on Accreditation of Rehabilitation Facilities (CARF), American Accreditation HealthCare Commission (URAC), College of American Pathologists (CAP), Commission on Cancer, Nuclear Regulatory Commission (NRC) and many more. Additionally, all VA medical centers are routinely reviewed by VA’s inspector general and at the request of Congress by the Government Accountability Office. Are VA’s medical staff processes different from yours? Not really. VA healthcare facilities credential pretty much the same way as private sector facilities, but you might be surprised by some of the differences and why. All licensed, registered and certified healthcare providers are credentialed in VA. So, in addition to the 57,000 LIPs, VA credentials an additional 130,000 healthcare providers whose occupations require licensure, registration or certification1 to practice. Licensure: As a federal healthcare entity, all licensed healthcare providers are required to have a full, active unrestricted license in any

Adverse Action History: VA medical centers always queried the NPDB-HIPDB and, in 2008, enrolled all LIPs in the continuous query process. Additionally, all physician applicants are queried against the Federation of State Medical Boards (FSMB) Disciplinary Alert Service (DAS) before initial appointment and then monitored through the DAS as long as they are appointed at a VA facility. VA staff must review the Health and Human Services (HHS) Office of the Inspector General (OIG) List of Excluded Individuals and Entities because the statute applies to the expenditure of all federal healthcare dollars, not just Medicare and Medicaid. Reporting to the NPDB-HIPDB: The Health Care Quality Improvement Act of 1986 requires the reporting of paid malpractice and adverse clinical privileging actions. In the case of claims against the federal government staff, the claim of negligent care is actually against the government, not against the provider, as all federal employees are “covered” by the Federal Tort Claims Act (FTCA 28 U.S.C 1346(b), 2671 – 2680) that waives sovereign immunity of the United States for negligent or wrongful acts of employees of federal agencies acting within the scope of their employment. Therefore, HCQIA required the Secretary of Health and Human services to enter into Memoranda of Understanding (MOU) with all federal healthcare entities.

This includes, but is not limited to, registered nurses, physical therapists, occupational therapists, respiratory therapists, social workers, nuclear medicine technologists, licensed practical nurses, dietitians, diagnostic radiologic technologists, therapeutic radiologic technologists, pharmacists, pharmacy technicians, dental assistants, dental hygienists, kinesiotherapists, recreation therapists, audiologists and speech-language pathologists.

SYNERGY September/O ctO ber 2012

Synergy - September/October 2012

Table of Contents for the Digital Edition of Synergy - September/October 2012