Rao bulletin 15 April 2016 html edition this bulletin contains the following articles
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- VA Hepatitis C Care Update 12 ► Estimated Cost $1B a Year
- Sovaldi and Harvoni
- VA Disability Evaluation System Update 02 ► Medical Exam Reports
- VA Reform Update 03 ► Separating Myth From Fact
- VA Health Care Access Update 35 ► Initiatives Progress
- VA Health Care Access Update 36 ► Wait Time Falsification
- “ VA OIG Wait Time Report Summary 2016 ”.
- VA Fraud, Waste Abuse ► Reported 1 thru 15 APR 2016 VAMC Cleveland
VA Services Update 01 ► Bad Ideas to Improve Them | DAV Operation: Keep the Promise (OKTP) is a yearlong effort to mobilize DAV and supporters behind their legislative agenda. In 2016, DAV will focus on veterans health care reform. Given the current policy debates about veterans health care, and proposals being put forward, we believe this is a defining moment for America’s veterans. Many of the ideas for reform have not been clearly defined by the people and organizations espousing them, so DAV has performed their own analysis of the impact on veterans. They encourage people to take a deeper look at the current proposals and ask thoughtful questions about how some reform ideas would affect veterans who choose and rely on VA for their care. They believe that many of these proposals are not good for veterans. “The real solution for veterans health care is to seamlessly integrate community care into an improved VA system to form local networks that ensure veterans get the best health care, when and where they need it.” Following is what DAV has to say about what they feel are five bad ideas for Vets: 1. Bad idea for veterans… Reducing VA to just “centers of excellence” will shrink the number of VA medical centers and clinics, putting them farther apart and primarily in urban areas. Hundreds of thousands of disabled veterans would be forced to travel farther or wait longer to access care. A better solution… Expand access and improve timeliness by creating a nationwide system of urgent care for veterans and expanding telemedicine and web-based health services. Listen to: https://support.google.com/youtube/?p=report_playback 2. A bad idea for veterans… Having the VA only treat combat or service-related injuries to reduce the demand for care is completely contrary to best practices in medicine – treating the whole patient. It will fracture care between VA and private providers, leading to less coordinated and lower quality care. A better solution… Ensure that VA resources are properly aligned with demand for necessary medical services, and are available when and where veterans need them. Listen to: https://www.youtube.com/watch?v=0zAOjbFELwc 3. A bad idea for veterans… Turning the VA into an insurance program to pay for private sector care will just create a new government bureaucracy, and get rid of all the expertise VA medical staff has regarding the unique needs of veterans. A better solution… Seamlessly integrate community care into the VA system to create veterans health care networks in every local market, providing a continuum of care for veterans and new, high-quality care options. Listen to: https://youtu.be/bY5Ir8KG1Ko. 4. A bad idea for veterans… Giving veterans plastic cards or vouchers to go buy health care in the private sector assumes that private providers are ready and able to take on the care of millions of veterans. They are not. A better solution… Empower veterans by eliminating arbitrary access standards, like the current 30-day and 40-mile standards for “choice,” and allow veterans and their doctors to decide when and where to get care, without bureaucrats in the middle. Listen to https://youtu.be/WXKthCMwtDo. 5. A bad idea for veterans… Privatizing VA health care or transferring governance of VA to an independent entity, similar to Amtrak or the U.S. Postal Service, will shift management of the VA to an unaccountable entity driven by corporate considerations, with little oversight by Congress or veterans themselves. A better solution… Transfer more of VA’s nonmedical support services, like construction, facility maintenance and IT infrastructure, to the private sector. Allow the VA to focus on its core mission of providing high-quality care to injured and ill veterans. Listen to: https://youtu.be/KXrw8z6q-IU. [Source: Disabled American Veterans | April 3, 2016 ++] ****************************** VA Hepatitis C Care Update 12 ► Estimated Cost $1B a Year The cost to taxpayers of treating Washington, D.C. area military veterans suffering from hepatitis C has eclipsed $64 million per year, according to a review of U.S. Department of Veterans Affairs records by the News4 I-Team. The fast-rising cost is attributed to a cutting-edge but expensive medication the agency began dispensing last year to veterans in Virginia, Maryland, D.C. and West Virginia. The new hepatitis C drugs, which are known as Sovaldi and Harvoni, are highly effective and less likely to cause side effects in patients, doctors and government officials said. Multiple reports estimate a full treatment of the medication costs tens of thousands of dollars per patient. Each individual pill costs an estimated $1,000, according to a report from a U.S. Senate panel. Agency records obtained by the I-Team from regional administrators of the U.S. Department of Veterans Affairs show 701 patients received the treatment at the Washington DC VA Medical Center in 2015. Those records show more than 200 patients were administered the medications at the Martinsburg VA Medical Center and more than 480 patients at Maryland’s VA medical system last year. In all, the cost of treatment exceeded $64 million, which is a $50 million increase from the cost of Hepatitis C treatment in 2014. All costs are covered by the U.S. Department of Veterans Affairs and federal taxpayers. Nationwide, the VA estimates the new treatment will cost $1 billion in 2016. But the agency said it has secured enough funding to expand the dispensation of the medicine to an increasing number of vets. “We’re honored to be able to expand treatment for veterans who are afflicted with hepatitis C,” VA Undersecretary for Health Dr. David Shulkin said in a statement. “To manage limited resources previously, we established treatment priority for the sickest patients. “ Chris Goldzwig, a military veteran from Brunswick, Maryland, said his treatment of Harvoni saved him from suffering severe liver failure. “It’s a miracle,” Goldzwig said. “If it wasn’t for this medicine, I wouldn’t be here.” Goldzwig, who received his treatment over the course of 16 weeks at the Martinsburg VA Medical Center, said the Harvoni pills were less rigorous and physically challenging than his previous hepatitis C treatment, an interferon regimen that Goldzwig called nauseating. Dr. Evelio Bravo, a physician at the Martinsburg VA Medical Center, said the pills have a very high success rate with local patients. “Years ago, the (older) treatment was very complicated with side effects,” Bravo said. “The patient would feel ill during the treatment.” “VA has long led the country in screening for and treating hepatitis C,” a statement from the U.S. Department of Veterans Affairs said. “VA has treated over 76,000 Veterans infected with hepatitis C and approximately 60,000 have been cured.” Members of Congress have criticized the manufacturer of the medicine for not offering a deeper discount to the U.S. Department of Veterans Affairs. “America's veterans deserve the same affordable access to life-saving medications such as sofosbuvir that Gilead is providing to patients in developing countries. If that’s not happening, the company’s leaders need to explain why,” said Rep. Jeff Miller (R-FL), chairman of the U.S. House Veterans Affairs Committee. A spokeswoman for Gilead, the manufacturer of Sovaldi and Harvoni, said price discounts are offered for the medication. “Most payers receive substantial discounts off this price, with the steepest discounts going to payers like Medicaid and the VA,” spokeswoman Cara Miller said. “Both the VA and Medicaid currently receive discounts in excess of 50 percent on Harvoni. With these rebates and discounts, the prices today are less than the cost of prior regimens.” [Source: NBC-4 Washington DC | Scott MacFarlane | April 3, 2016 ++] ****************************** VA Disability Evaluation System Update 02 ► Medical Exam Reports The Department of Veterans Affairs has awarded three companies positions on a potential five-year, $6.8 billion contract vehicle to process medical exam reports in order to help facilitate the delivery of disability claims benefits to retired service personnel. The VA said 29 MAR it awarded 12 contracts to VetFed Resources, Veterans Evaluation Services and QTC Medical Services through the Medical Disability Examination Program in support of the MyVA initiative. Contracts awarded under the vehicle cover work for one base year and up to four option years. “The goal will be to reduce the veteran’s wait times for examinations as much as possible thereby providing faster claims decisions and enhancing veterans’ experience in a positive way,” said Tom Murphy, acting principal deputy undersecretary for benefits at the VA. The Medical Disability Examination Program seeks to consolidate medical examinations contracts into a single contract vehicle that is managed by a central management team with representatives from both the Veterans Health Administration and the Veterans Benefits Administration. A VA strategic acquisition center in Frederick, Maryland will oversee the enterprisewide contract. [Source: GovConWire | Jane Edwards | March 30, 2016 ++] ****************************** VA Reform Update 03 ► Separating Myth From Fact Hardly a day goes by without another headline about problems in the U.S. Department of Veterans Affairs health-care system and the veterans suffering as a result. But in recent weeks, a number of politicians and journalists have downplayed or even denied the need for reforming the VA, instead accusing those calling for change of “manufacturing or vastly exaggerating” its deficiencies. These denials fly in the face of everything uncovered in the massive wait-list scandal at the VA nearly two years ago, and the tens of thousands of veterans still waiting months for care. For anyone who thinks these problems aren’t real, consider the story of Barry Coates, a veteran who passed away earlier this year after a long fight with cancer. Barry, a South Carolinian in his mid-40s when he died, testified before Congress in the aftermath of the 2014 scandal, noting that he had waited a full year for the VA to give him a colonoscopy and even had to beg for it to be performed. By the time the VA gave him his appointment, his cancer had already progressed too far. Unfortunately, Barry’s story is far from the only one. And ignoring stories like his won’t improve veterans’ health and well-being. Veterans deserve an honest assessment of the problems within their VA. We must first confront the continued excessive wait times for access to health-care. VA staff were encouraged to manipulate the numbers when patients were waiting too long for treatment, hiding these long waits and allowing them to go unchecked. This most infamously occurred in Phoenix, Arizona, where CNN initially reported that at least 40 veterans died while waiting on secret wait lists. A VA Inspector General’s report later confirmed this, noting that thousands of veterans were at risk. Far from isolated to Arizona, the VA’s own investigations later revealed these wait lists and excessive delays in treatment were systematic across the nation. The reports produced by these investigations are only now being released, confirming that supervisors and staff at facilities across Texas, Florida, Arkansas, and Delaware—to name a few—falsely indicated that veteran’s wait times were zero. Worse yet, this practice continued at least as far back as 2007. This evidence is damning, yet excessive wait times are hardly the only major problem with veterans’ treatment. Stories abound of VA staff behaving unethically or negligently but receiving little disciplinary action. Just this month, for example, two high-level employees demoted for allegedly exploiting the personal relocation system for their own gain were reinstated with full pay. That’s because bureaucracy makes it almost impossible to fire VA employees who’ve committed wrongdoing—at least not in a timely manner or without a protracted battle. Outside observers have confirmed the decline in VA quality. An independent assessment mandated by Congress, conducted last year by consulting firms including McKinsey and RAND, found that VA hospitals and facilities provide “strikingly different patient experiences, apply inconsistent business processes, and differ widely on key measures of performance and efficiency." And if anyone still continues to doubt, they only need to look at the VA’s own data, which show conditions at the VA continue deteriorating. Troubled VA facilities such as Phoenix still have excessive wait times. Over 8,000 appointments for care in Phoenix have wait times of one month or longer. And it’s even worse in Columbia, South Carolina, where Barry Coates failed to get the care he needed. As of March 1st, over 13 percent of appointments made for care there have one-month wait times, with over 1,000 delayed longer than 120 days. And the problems are still getting worse. Last year the number of backlogged veterans was 50 percent higher than at the height of the wait-list scandal. And as of this past January, over 30,000 more veterans are waiting longer than one month for health care than were in January 2015. This is unacceptable, but how do we fix it? One of the most important changes is ensuring veterans have the freedom to choose how and where they use their health care benefits. That could be accomplished through a strengthened version of 2014’s “Veterans Choice Act” The opponents of VA reform say this is akin to “privatizing” the agency, but that couldn’t be further from the truth. It’s actually like giving veterans a “GI Bill” for their health care. It makes complete sense to take advantage of our country’s well-developed civilian medical infrastructure to supplement veterans’ care when the VA can’t guarantee it. Those who staunchly defend the VA in light of the indefensible suffering it often causes are putting the federal bureaucracy ahead of the veterans it’s supposed to serve. The VA is a critical institution that serves a noble purpose, but ignoring the need for serious reforms will only hurt more of our nation’s heroes. [Source: The Hill | Peter Gaytan | April 1, 2016 ++] ****************************** VA Health Care Access Update 35 ► Initiatives & Progress The Department of Veterans Affairs’ (VA) top health care official announced progress and new steps VA is taking to improve Veterans access to health care. Dr. David J. Shulkin, Under Secretary for Health, announced the measures during a briefing to a group of more than 100 journalists attending the Association of Health Care Journalists’ conference 8 APR in Cleveland, Ohio. “We are working to rebuild the trust of the American public and more importantly the trust of the Veterans whom we are proud to serve,” said Dr. Shulkin. “We are taking action and are seeing the results. We are serious about our work to improve access to health care for our nation’s Veterans. We want them to know that this is a new VA.” During the briefing, Dr Shulkin discussed a new initiative, MyVA Access. MyVA Access represents a major shift for VA by putting Veterans more in control of how they receive their health care. It is a top priority for VA’s Veterans Health Administration (VHA). MyVA Access is a declaration from VHA employees to the Veterans they care for; it is a call to action and the reaffirmation of the core mission to provide quality care to Veterans, and to offer that care as soon as possible to Veterans how and where they desire to receive that care. The initiative ensures that the entire VA health care system is engaged in the transformation of VA into a Veteran-centered service organization, incorporating aspirational goals such as same day access to mental health and primary care services for Veterans when it is medically necessary. At present, 34 VA facilities offer same-day appointments, and as a practicing physician, Dr. Shulkin currently sees Veterans needing same-day appointments at the VA Medical Center in Manhattan. VA is hoping to be able to offer same day appointments when it is medically necessary at all of its medical centers by the end of 2016. In addition, Dr. Shulkin introduced a new smart phone app called the Veteran Appointment Request App. This app allows Veterans to view, schedule and cancel primary care and mental health appointments as well as track the status of the appointment request and review upcoming appointments. It is currently available in 10 locations and has received positive feedback from the vast majority of Veterans using the app. VA expects to make the app available to all Veterans by early 2017. Other efforts underway include a website enhancement that will allow Veterans to check wait times in real time where ever they live – this includes new and existing patients and a new, easy-to-use scheduling software program. The new program is being piloted in 10 sites and is expected to reduce scheduling errors and enhance VA’s ability to measure and track supply, demand and usage. MyVA Access is part of MyVA, introduced in 2014 by VA Secretary Robert McDonald following one of the most challenging times in the history of VA. MyVA is centered around the needs of Veterans by putting them first in everything VA does. Since that time, VA has made significant progress in addition to the new initiatives announced by Dr. Shulkin. Among the health care progress made:
[Source: VA News Release | April 08, 2016 ++] ******************************* VA Health Care Access Update 36 ► Wait Time Falsification USA Today reports that findings from the VA Inspector General’s report about VA supervisors instructing staff to falsify patient wait times at Veterans Affairs medical facilities in at least seven States to show they met performance measures. The USA Today article reports on the wide-spread scheduling manipulation was throughout the VA in 2014. It said the manipulations gave the false impression that wait times at facilities in Arkansas, California, Delaware, Illinois, New York, Texas and Vermont met agency targets. Refer to VA’s Undersecretary of Health video http://videos.usatoday.net/Brightcove2/29906170001/2016/04/29906170001_4832920198001_4832803806001.mp4 to listen to the importance of having correct data on wait times. The article is based on 70 reports released following a Freedom of Information Act request from USA Today. About half of the 70 reports are from investigations that were completed more than a year ago. Investigations launched by the inspector general into more than 100 facilities after the Phoenix scandal found that manipulations had been going on in some cases for as long as a decade. In efforts to help resolve the problems Dr. Shulkin, VA Undersecretary for Health says, “We’ve expanded appointments, we have added evening hours and weekend hours, we’ve added 3 million square feet of space, we’ve hired 14,000 new providers.” But VA whistle-blowers say schedulers still are manipulating wait times. Shea Wilkes, co-director of a group of more than 40 whistle-blowers from VA medical facilities in more than a dozen States, said the group continues to hear about it from employees across the country who are scared to come forward. “Until the VA decides it truly wants to change its corrupt and poor culture, those who work on the front lines and possess the true knowledge relating to the VA's continued data manipulation will remain quiet and in hiding because of fear of workplace harassment and retaliation,” said Wilkes, a social worker at the VA Medical Center in Shreveport, La. To read the conclusions of the reports published to date refer to the attachment to this Bulletin titled, “VA OIG Wait Time Report Summary 2016”. NAUS Note: The House Veterans’ Affairs Committee has been working to address many of the problems in the VA system. We question where the Senate Veterans’ Affairs Committee and Chairman Sen. Johnny Isakson (R-GA) have been? Delays and lack of action leave us baffled. Why is the SVAC not exercising more of its oversight responsibilities with the urgency these types of scandalous reports demand? [Source: NAUS Weekly Update | April 08, 2016 ++] ******************************** VA Fraud, Waste & Abuse ► Reported 1 thru 15 APR 2016 VAMC Cleveland — A Washington D.C. area architect was sentenced 30 MAR to 33 months in prison for bribing the former head of the Louis Stokes VA Medical Center in Cleveland in exchange for privileged information projects for the Department of Veterans Affairs. Mark Farmer, 55, apologized for his actions and accepted responsibility on Tuesday in a sentencing hearing that stretched over two days. He said he should have known that the information that William Montague, the former head of the Cleveland VA, provided was privileged and should not have bribed him. "I've lost almost everything except my family, and I have set a very poor example for them," Farmer said. Farmer, of Arlington, Virginia, initially faced a prison sentence of nearly 20 years after a jury found him guilty in August for his role in the Cuyahoga County corruption scandal. However, he struck a deal with federal prosecutors for a prison sentence of between 21 months and six years. U.S. District Judge Sara Lioi, in sentencing Farmer, said she felt that Farmer should face a sentence that is proportional to Montague, who is awaiting sentencing on more than five-dozen felony counts. Under a plea deal, Montague is looking at a sentence of as little as 4 1/2 years. Lioi fined Farmer $12,500 and ordered him to forfeit $70,801.64, roughly the amount that he bribed Montague. His attorney requested that Farmer be placed at a minimum security prison in Morgantown, West Virginia. Lioi said she would make the recommendation. Farmer was convicted of 14 felonies, including conspiracy, racketeering, embezzlement, theft of public money, mail fraud and wire fraud. Farmer has been in jail since the jury's verdict. A jury found that Farmer colluded with Montague between 2010 and 2013 after Montague left the Cleveland VA and while he worked as the interim head of the VA in Dayton. During this time, Montague, a Brecksville resident, also ran the consulting firm "House of Montague." Montague testified at trial that he obtained and sent along confidential information so that CannonDesign could have an advantage when submitting bids on upcoming projects. Farmer's employer then used the confidential information to prepare a proposal to be chosen as the architectural firm to design a veterans' hospital in West Los Angeles, California. Assistant U.S. Attorney Antoinette Bacon, in arguing for a higher sentence, gave Lioi a refresher on the county corruption investigation and how Farmer's scheme fit into the timeline. In 45 minutes of remarks, Bacon showed that Farmer was working with Montague on a Cleveland VA project in 2008, around the same time that agents from the FBI and the Internal Revenue Service raided the homes and businesses of several Cleveland-area contractors and public officials. Later, when Farmer started bribing Montague, the case against former Cuyahoga County Commissioner Jimmy Dimora case was well underway, and they continued even as Dimora was tried and found guilty. "He had warning flags. He had the ability to stop, but instead he barreled ahead," Bacon said of Farmer. The prosecutor also tried to compare Farmer's actions to Ferris Kleem, William Neiheiser and Steven Pumper, three Cleveland-area contractors who were sentenced in the corruption case. Kleem and Neiheiser served three-year prison sentences and Pumper is serving an eight-year stint. Bacon said that Farmer's case should be weighed against theirs and penalized accordingly because his bribes were higher and the benefits to his firm — worth roughly $3.9 million — were too. John Mitchell, Farmer's attorney, argued for a lower sentence because Farmer's career has been irreparably damaged by the case. He said his client will be banned from bidding on federal projects and will lose his architectural license. He also said Farmer is "beating himself up as much as anybody." Montague was the only federal official charged in the county corruption scandal, which yielded convictions against more than 60 people. He has pleaded guilty to accepting money from several contractors. [Source: Cleveland.com | Eric Heisig | March 30, 2016 ++] Directory: wp-content -> uploads -> 2016 2016 -> 2017 afoCo Landmark Scholarship Program 2016 -> Instructions for the Preparation of Camera-Ready Contributions to the Conference Proceedings 2016 -> Step student Scholarships for Year 10-13 2016 -> The united church of canada 2016 -> Idan raichel biography – May 2016 Brief Producer, keyboardist, Lyricist, composer and Performer Idan Raichel 2016 -> An introduction to centre’s interventions expanding access to justice 2016 -> Sanchar Shakti 2016 -> Unit analysis should help here. We want number of bananas 2016 -> The Autobiography of Elder Joseph Bates 2016 -> The Great Heat and the Rhode Island Deep Water Bay Scallop (Argopecten irradians) Fishery 1875-1905 Download 0.88 Mb. Share with your friends:
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