Washington Highlights: February
25, 2005
VA OIG Releases
Report on Sole-Source Contracts with Affiliated Medical Schools
Contents
Prior Issues
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The Department of Veterans Affairs (VA) Office of the Inspector
General Feb. 16 released a report
criticizing the way sole-source contracts are awarded by VA medical
centers to affiliated medical schools and practice groups. The report,
"Evaluation of VHA Sole-Source Contracts With Medical Schools
and Other Affiliated Institutions," addresses three primary
issues: general contracting issues, contract pricing, and conflict
of interest and other legal issues. The report concludes, "some
contracts were awarded to meet the needs of the affiliate, not the
VA" and that "VA was overpaying the affiliates for services
provided" at both the affiliate and at the VA.
Some of the specific criticisms leveled in the report include:
- "VHA facilities are using sole-source contracts with
affiliates to acquire services without sufficient evidence that
the services could not be required through direct hiring or
that sole-source contracts were in the best interests of the
Government."
- "In some cases, the affiliates even dictated the terms
and conditions, including the number and type of personnel needed."
- "VHA is not complying with the requirement to refer
proposals to the OIG for pre-award review."
- "Solicitations do not require the identification of
key personnel who will be providing services under the contract…this
often results in VA paying excessive prices for the services
provided."
- "[G]iven the fact that the basis for allowing sole-source
agreements with the affiliate is to maintain the mutually beneficial
relationship involving the training of medical students and
residents, we question whether the affiliate should be making
a profit off the VA."
- "We identified situations where VA physicians, who have
a financial interest in the affiliate and/or the affiliates
practice group, are involved in the contracting process in violation
of Federal ethics laws and regulations."
VA Under Secretary for Health Jonathan Perlin, M.D., Ph.D., concurred
with the report's conclusions, noting, "VHA recognizes that
flaws exist in contracting processes throughout the system and that
effective accountability controls are lacking." Dr. Perlin
convened a committee to review the report and develop a plan of
corrective action, which is included in the report.
Information:
Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs
AAMC Government Relations
jfishburn@aamc.org
(202) 828-0525
AAMC Endorses Expanded SLID Provisions
The AAMC joined 29 other health professions groups in a Feb. 22
letter to Rep.
Phil English (R-Pa.) in support of his proposal to expand the provisions
of the Student Loan Interest Deduction (SLID). Similar to legislation
he introduced in the 108th Congress, Rep. English's proposal is
expected to allow borrowers to deduct the full amount of interest
paid on their student loan, and to increase the income eligibility
cap to $100,000 for taxpayers filing singly, and to $200,000 for
taxpayers filing jointly.
Information:
Jonathan Fishburn, Director, Research, Education and Veterans' Legislative Affairs
AAMC Government Relations
jfishburn@aamc.org
(202) 828-0525
AHRQ Releases 2004 Quality and Disparities Reports
The Agency for Healthcare Research and Quality (AHRQ) Feb. 22 released
the second annual reports
on quality and disparities in health care. The reports build upon
the baseline data on quality and disparities within health care
delivery provided in AHRQ's 2003 reports [see Washington
Highlights, Jan. 9, 2004].
Compared to the 2003 report, there have been modest improvements
for many quality measures. For example, quality has improved by
approximately 3 percent versus 2003 data, according to measures
used by the Centers for Medicare & Medicaid Services, the Joint
Commission on Accreditation of Healthcare Organizations, the National
Committee for Quality Assurance, and others for quality reporting
on hospitals, nursing homes, home health agencies and other settings.
While the report cautions policymakers that change takes time and
quality remains variable across the country, it notes that best
practices have been identified and stakeholders have made inspiring
gains.
The disparities report presents data on clinical conditions, such
as cancer, diabetes, and heart disease, with a focus on specific
priority populations, including women, children, the elderly, racial
and ethnic minority groups, low-income groups, residents of rural
areas, and individuals with special health care needs. The report
identifies three key themes: disparities are pervasive; improvement
is possible; and gaps in information exist, especially for specific
conditions and populations.
Information:
Erica Froyd, Director, Public Health and Research Legislative Affairs
AAMC Government Relations
efroyd@aamc.org
(202) 828-0525
Perlin Nominated as VA Under Secretary for Health
President Bush Feb. 18 formally nominated Jonathan Perlin, M.D.,
Ph.D., to be Under Secretary for Health at the Veterans Health Administration
(VHA). Dr. Perlin has served as Acting Under Secretary for Health
since April 2004. He previously served as Deputy Under Secretary
for Health and as Acting Chief Research and Development Officer
from December 2003 to July 2004. Dr. Perlin was VHA's Chief Quality
and Performance Officer from 1999 to 2002. Prior to joining VHA,
Dr. Perlin served as Medical Director, Quality Improvement at the
Medical College of Virginia Hospitals - Virginia Commonwealth University
(VCU) Health System. At VCU, he helped establish the Health Services
Research Fellowship in the Division of Quality Health Care, Department
of Internal Medicine, and was Associate Director of the Internal
Medicine Residency Training Program. He received his Ph.D. in pharmacology
and toxicology (performing research in molecular biology) with his
M.D. as part of the Medical Scientist Training Program at Virginia
Commonwealth University's Medical College of Virginia Campus.
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