VA and Medicare Team Up to Root Out Cheating Civilian Doctors

The Department of Veterans Affairs is working with the Department of Health and Human Services' Centers for Medicare and Medicaid Services (CMS) to fight fraud in its community care programs, most notably the Mission and the Civilian Urgent Care programs.

In a news release, the VA announced the two agencies will compare information on questionable veteran health care providers in both VA treatment facilities and through purchased care programs in their communities.

The VA said it will begin receiving data on physicians who have received Medicare sanctions from CMS before the end of the year. The VA will also share its data regarding fraud or questionable treatments with CMS.

The plan is to share data between the two agencies on a regular basis.

"CMS is an industry leader when it comes to identifying questionable providers and nefarious medical practices," said VA Secretary Robert Wilkie. "Their willingness to partner with VA puts veterans first by allowing us to identify providers who do not meet our quality standards."

Medicare sanctions include abusive billing practices, felony convictions and improper prescribing practices. The VA will review data on physician sanctions received from CMS to screen potential and current VA medical employees and to determine whether a civilian provider should be a participant in its community care programs.

"CMS is proud to work with VA and share our innovative data analytics and best practices for detecting and preventing potential fraud, waste and abuse across other federal health care programs to improve care to our nation's veterans," said CMS Administrator Seema Verma.

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