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Veterans' Health Care: Improved Oversight of Community Care Physicians Credentials Needed

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Technical Report

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U.S. Government Accountability Office Washington United States

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To help ensure that veterans are provided timely and accessible health care, VHA purchases care from community physicians. Two community care programs, PC3 and Choice, require physicians to hold certain credentials reflecting their qualifications. Congress included a provision in law for GAO to review VHAs processes for, and oversight of, credentials verification for PC3 and Choice physicians. This report examines 1 whether VA contractors comply with contractual requirements for verifying PC3 and Choice physicians credentials 2 the extent to which VHA oversees the contractors responsible for verifying the credentials of PC3 and Choice physicians and 3 VHAs own processes for, and oversight of, verifying Choice physicians credentials under recently implemented VHA Choice provider agreements. GAO reviewed PC3 and Choice contracts, VHA and contractor policies, and federal internal control standards. GAO reviewed a nongeneralizable sample of 50 PC3 and 50 Choice physician credentials files, selected among five types of care across the nation. GAO also interviewed VHA officials and contractor representatives.

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