A year before Tanner Johnson was due to graduate from the U.S. Air Force Academy in Colorado, he was lying in a hospital bed and doctors were telling his family he had two hours to live.

His organs were shutting down due to complications caused by Type 1 diabetes, an autoimmune condition where the body attacks the cells that make insulin.

Type 1 diabetes usually affects young children and runs in families, but none of Johnson's relatives were diabetic. He was nearly 22 when he was diagnosed in May 2020, two months after most cadets had been sent home as the academy scrambled to contain the fast-spreading coronavirus.

Johnson pulled through the worst of the health crisis and began to deal with his new reality.

"The doctors said I would have to take insulin shots every day for the rest of my life, I would not be able to fly, I would not be allowed in the military, and wouldn't be allowed to return to the academy and graduate," Johnson said.

But he refused to accept what they said and set out to prove them wrong. He hoped to become the first person to be commissioned into the U.S. military with a medical condition that, up until then, was automatically disqualifying.

"If you have Type 1, you become not deployable because you are taking insulin shots," said Lt. Col. Amy Carpenter, an assistant professor of biology at the academy and a certified diabetes counselor.

During her first decade in the military, Carpenter advised newly diagnosed service members about living with diabetes and prepared them for the end of their military career.

Academy officials allowed Johnson to return and he was referred to Carpenter for counseling. But that wasn't what he was looking for.

"He came to me and said, 'Ma'am, I know this is a long shot, but what if we could demonstrate that being a Type 1 diabetic does not have to be an automatic disqualifier?'" Carpenter said.

"I thought, 'oh man, I've never had an example where you have Type 1 diabetes and the military retains you.' So I told him, 'Tanner, I know you're in great control, you're very knowledgeable about your condition, but get ready to get kicked out.'"

He didn't. Instead, Johnson did "what everyone else did, and then some, to show that even with this condition, I could do everything that was required of me, and do it well," he said.

He continued competing with the wrestling team during his senior year, with the tiny needle of a continuous glucose monitor in his stomach, he said. He signed up for more activities and raised his grade point average to the highest it had ever been.

And he talked to anyone who would listen about why he should be allowed to commission, laying out convincing arguments, including that technology has made it possible for diabetics to live nearly normal lives.

Insulin pumps can deliver a steady, 24-hour stream of the vital hormone, with a boost at mealtimes, while continuous glucose monitors keep tabs on blood sugar.

"Ten, 15 years ago, that technology didn't exist," Carpenter said. "With it, it's no longer true that, 'oh my God, I can't fly this airplane anymore because I have to prick my finger and check my blood sugar or give myself a shot.' Now, a diabetic can just look at their smartwatch and see that their blood sugar's dropping too low, so they'd better drink some orange juice."

With Carpenter's help, Johnson conducted independent research into Type 1 diabetics in the military and other professions.

He found that they serve as police, firefighters and in other frontline roles, and that the Federal Aviation Administration last year approved the first commercial pilot with Type 1 diabetes. He uses a continuous glucose monitor, like Johnson does.

There are no precedents for diabetics in the military, although Army Sgt. Joshua Kirkpatrick, of the 449th Theater Aviation Brigade, won the North Carolina National Guard's NCO Best Warrior of the year competition in 2017 – three years after he was diagnosed with Type 1 diabetes.

He entered the competition "because from day one when I was diagnosed with diabetes, they were constantly telling me that I'm unfit for the Army," Kirkpatrick said in an interview posted on the Defense Visual Information Distribution Service at the time. "They said there's no way I can compete with everybody else, and constantly I showed them I could."

Attempts to reach Kirkpatrick for comment were unsuccessful. His former unit said he had left the Guard. The DVIDS report said proceedings were underway in 2017 to discharge him.

With time counting down to the day Johnson would have to leave the Air Force Academy, he continued to plead his case to be allowed to commission. Last fall, he approached academy superintendent Lt. Gen. Richard Clark and asked if he could have 10 minutes of his time.

"We spoke for nearly an hour," Johnson recalled. "He said if I could wrestle and do everything required of me at the academy, there was no reason we couldn't find a job for me in the military. And he went to bat for me."

There were still times when it seemed that he'd fail, but just weeks before the Class of 2021 became the largest graduating class in academy history on May 26, Johnson learned he would march into the football stadium with his squadron, wearing a grey sash to indicate that he was joining the Space Force.

Johnson and his wife, Brynn, arrived last week at Vandenberg Space Force Base in California, where the newly minted second lieutenant hopes to become an orbital warfare officer and help the U.S. use satellites to give it an advantage in space, he said.

He also hopes he can spur change and spare others the anguish he went through when he was diagnosed. He wants to be "the guy who demonstrates that the policy should change," not the exception to an existing rule, Carpenter said.

"I was devastated to learn I had diabetes, and then I had to deal with the fact that everything I'd worked for might be taken away because the military might not accept me," he said. "I want to be an example so that, when someone is diagnosed in the future, they won't have that hanging over them.

"I want people to say, 'Look at this guy, look at what he's doing.' I may never be an astronaut, like my mom seems to think I will, but I can manage my condition and serve my country," he said.

"And if the astronaut door ever opens to diabetics," he added after the briefest reflection, "I'll walk through it."

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An Ohio physician was sentenced to two years in prison today for his role in illegally distributing opioids.

Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division, U.S. Attorney David DeVillers of the Southern District of Ohio, Special Agent in Charge Keith Martin of the Drug Enforcement Administration’s (DEA) Detroit Division, Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office, Special Agent in Charge William C. Hoffman of the FBI’s Cincinnati Field Office, Ohio Attorney General Dave Yost, Interim Administrator/CEO John Logue of the Ohio Bureau of Worker’s Compensation, and Executive Director Steven W. Schierholt of the State of Ohio Board of Pharmacy made the announcement.

Morris Brown, M.D., 73, of Dayton, pleaded guilty to one count of unlawful distribution of controlled substances on Feb. 21, 2020.

Brown was charged in an April 2019 indictment along with four co-defendants: Ismail Abuhanieh, 50, of Phoenix, Arizona; Mahmoud Elmiari, 44, of Bellbrook, Ohio; Yohannes Tinsae, 48, of Beavercreek, Ohio; and Mahmoud Rifai, 50, of Detroit, Michigan. All four of Brown’s co-defendants were charged for their roles in agreeing to obtain controlled substances by fraud or misrepresentation for Dayton Pharmacy, which leased space in a building owned by Brown.. Abuhanieh, Elmiari, and Tinsae have been sentenced pursuant to guilty pleas. Rifai is the subject of an active arrest warrant in connection with the case.

The DEA, FBI, HHS-OIG, Ohio Attorney General’s Office, Ohio Bureau of Worker’s Compensation, and Ohio Board of Pharmacy investigated the case. Trial Attorneys Chris Jason, Tom Tynan, and Leslie Garthwaive of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the ARPO Strike Force. Since its inception in October 2018, the ARPO Strike Force, which operates in 10 districts, has charged more than 85 defendants who are collectively responsible for distributing approximately 65 million pills. The ARPO Strike Force is part of the Health Care Fraud Strike Force Program, led by the Fraud Section. Since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for approximately $19 billion. In addition, the U.S. Department of Health and Human Services (HHS) Centers for Medicare & Medicaid Services, working in conjunction with the HHS-Office of Inspector General, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Individuals who believe that they may be a victim in this case should visit the Fraud Section’s Victim Witness website for more information.

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An Ohio physician was sentenced to 40 months in prison today for his role in illegally distributing controlled substances.

George Griffin, M.D., 71, of Cincinnati, pleaded guilty to one count of unlawful distribution of controlled substances on Oct. 5, 2020.

According to court documents, Griffin prescribed controlled substances to patients in amounts and for lengths of time that were outside the scope of legitimate medical practice. Griffin routinely prescribed controlled substances to patients even though various “red flags” suggested that he should stop writing those prescriptions, change the prescriptions, and/or counsel patients accordingly. Further, according to court documents, Griffin prescribed dangerous combinations of drugs known to heighten the risk of overdose and death.

Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division; Acting U.S. Attorney Vipal Patel of the Southern District of Ohio; Special Agent in Charge Keith Martin of the Drug Enforcement Administration’s (DEA) Detroit Division; Special Agent in Charge William “Chris” Hoffman of the FBI’s Cincinnati Field Office; and Special Agent in Charge Lamont Pugh III of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Chicago Regional Office made the announcement.

The DEA; FBI; HHS-OIG; Ohio Attorney General’s Office; Ohio Bureau of Worker’s Compensation; and Ohio Board of Pharmacy investigated the case.

Trial Attorneys Chris Jason, and Katherine Pridemore of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Appalachian Regional Prescription Opioid (ARPO) Strike Force. Since its inception in October 2018, the ARPO Strike Force, which operates in 10 districts, has charged 91 defendants, including 68 licensed medical professionals, and its casework has targeted the alleged illegal distribution of more than 65 million controlled substance pills involving more than 350,000 prescriptions. Since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for approximately $19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Individuals who believe that they may be a victim in this case should visit the Fraud Section’s Victim Witness website for more information.

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Earlier today, in federal court in Central Islip, Michael Belfiore, a former medical doctor, was sentenced by United States Circuit Judge Joseph F. Bianco to 23 years in prison for the illegal distribution of oxycodone causing the deaths of two patients and the illegal distribution of oxycodone to those patients and to an undercover detective. In addition, Belfiore was ordered to forfeit $7,270 in illegal fees that he took from the two deceased patients and the undercover detective and to pay $17,000 in restitution based upon costs associated with the overdose deaths that he caused. Belfiore was convicted of the charges by a federal jury in May 2018 following a five-week trial. Belfiore’s medical license has lapsed and he is no longer practicing medicine.

Breon Peace, United States Attorney for the Eastern District of New York, Keith Kruskall, Acting Special Agent-in-Charge, Drug Enforcement Administration, New York Division (DEA), and Patrick J. Ryder, Commissioner, Nassau County Police Department (NCPD), announced the sentence.

“In violation of his oath to do no harm, Belfiore intentionally distributed highly addictive and potentially lethal opioids in dosages and quantities that resulted in the overdose deaths of two of his patients,” stated United States Attorney Peace. “Today’s sentence sends a strong message that this Office and its law enforcement partners will fight the opioid epidemic and seek serious punishment for medical professionals like Belfiore who betray their profession and use their prescription pads to further addiction, rather than as a tool to heal. I want to extend my sincere thanks to DEA’s Long Island Tactical Diversion Squad, who tenaciously investigated this case.”  

“During the midst of an opioid epidemic, the defendant chose to use his education and medical training to do harm, and at the expense of two of his patients’ lives,” stated DEA Acting Special Agent-in-Charge Kruskall. “DEA and its law enforcement partners will continue to seek justice for the victims who have been betrayed and have suffered greatly at that hands of those who were trusted with their health and wellbeing.”

Belfiore, a former doctor of osteopathic medicine who primarily operated out of an office in Merrick, New York, illegally distributed oxycodone outside the usual course of professional practice and not for a legitimate medical purpose.   Oxycodone is a powerful and highly addictive drug that is increasingly abused because of its potency when crushed into a powder and ingested. It is a controlled substance that may be dispensed by medical professionals only to patients suffering from significant pain that is documented through medical exams, diagnostic testing—such as x-rays and MRIs—and other objective proof. Although oxycodone is commonly prescribed in five milligram tablets, the trial evidence showed that Belfiore wrote thousands of 30 milligram prescriptions for oxycodone in quantities of up to 180 pills per month.

At trial, the evidence established that on February 28, 2013, Belfiore gave an illegal prescription for 120 30 mg oxycodone pills to 42-year-old Edward Martin.   On March 5, Mr. Martin overdosed and died in his bed after snorting the oxycodone obtained from Belfiore’s prescription. On April 12, 2013, Belfiore gave an illegal prescription for 150 30 mg oxycodone pills to 32-year-old John Ubaghs. On April 13, 2013, Mr. Ubaghs was found unresponsive after overdosing on oxycodone prescribed by Belfiore, and was pronounced dead at the hospital.

Between March 2013 and August 2013, Belfiore intentionally dispensed six prescriptions of oxycodone without a legitimate medical purpose to an undercover detective with the NCPD’s Narcotics Vice Squad. Belfiore created fake medical charts to justify those prescriptions and during office meetings with the undercover detective, Belfiore’s “treatment” consisted of a discussion of the defendant’s trip to San Diego and his interest in helicopters, yachts and cigarette boats.  

The case was investigated by the DEA’s Long Island Tactical Diversion Squad comprising agents and officers of the DEA, NCPD, Suffolk County Police Department, Port Washington Police Department and the U.S. Department of Health and Human Services, Office of Inspector General.

The government’s case is being handled by the Office’s Long Island Criminal Division. Assistant United States Attorneys Charles N. Rose and Bradley T. King are in charge of the prosecution.

The Defendant:

MICHAEL BELFIORE

Age: 58

Westbury, New York

E.D.N.Y. Docket No. 15-CR-242 (JFB)

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A federal grand jury in Charleston, West Virginia, today returned a seven-count indictment charging Dr. Jonathan Yates, 51, with federal civil rights and abusive sexual contact offenses. Yates, a doctor of osteopathic medicine who formerly worked at the Veterans Affairs Medical Center in Beckley, West Virginia, is charged with five counts of depriving Veterans of their civil rights under color of law, in violation of Title 18, United States Code, Section 242, and two counts of abusive sexual contact, in violation of Title 18, United States Code, Section 2244(b). He was previously charged in a criminal complaint with depriving a Veteran of his civil rights under color of law.

The indictment alleges that between September 2018 and February 2019, while working at the Veterans Affairs Medical Center, Dr. Yates examined six male patients, identified in the indictment as Veterans One through Six, and sexually molested them during their appointments. The indictment alleges that Yates temporarily immobilized two of the Veterans – one by cracking his neck, and the other with the use of acupuncture needles – and sexually molested them while they were incapacitated. The indictment also alleges that his abuses caused five of the Veterans to suffer bodily injury. This conduct, performed while Dr. Yates was acting under color of law in his capacity as a federal employee at the VAMC, deprived Veterans One through Five of their constitutional right to bodily integrity. The indictment also alleges that Yates knowingly engaged in sexual contact with Veterans Two and Six without their consent.

This investigation remains ongoing. Anyone with additional information is encouraged to contact the FBI at 1-800-CALL-FBI (225-5342).

An indictment is merely a formal accusation of criminal conduct. The defendant is presumed innocent unless and until he is proven guilty beyond a reasonable doubt in a court of law.

If convicted, Yates faces a statutory maximum sentence of life in prison.

Assistant Attorney General Eric Dreiband and U.S. Attorney Michael B. Stuart for the Southern District of West Virginia commended the investigative efforts of the FBI, the Department of Veterans Affairs Office of Inspector General, and the Veterans Affairs Police Department in this matter.

The case is being prosecuted by Special Litigation Counsel Samantha Trepel and Trial Attorney Kyle Boynton of the Civil Rights Division of the U.S. Department of Justice and Assistant U.S. Attorney Greg McVey of the Southern District of West Virginia.

Related court documents and information may be found on the website of the District Court for the Southern District of West Virginia at http://www.wvsd.uscourts.gov/ or on http://pacer.wvsd.uscourts.gov/.

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A federal jury convicted a New Jersey rheumatologist today for defrauding Medicare and other health insurance programs by billing for services that patients never received.

According to court documents and evidence presented at trial, Alice Chu, 64, of Fort Lee, owned and operated a rheumatology practice in Clifton. From 2010 through 2019, Chu billed Medicare and other health insurance programs for expensive infusion medication that her practice never purchased. Chu also fraudulently billed millions of dollars for allergy services that patients never needed or received.

Chu was convicted of one count of conspiracy to commit health care fraud and five counts of health care fraud. She is scheduled to be sentenced on July 14 and faces a maximum penalty of 10 years in prison for each count. A federal district court judge will determine any sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

Assistant Attorney General Kenneth A. Polite Jr. of the Justice Department’s Criminal Division; Assistant Director Luis Quesada of the FBI’s Criminal Investigative Division; Special Agent in Charge George M. Crouch Jr. of the FBI’s Newark Field Office; Special Agent in Charge Scott J. Lampert of the Department of Health and Human Service Office of the Inspector General (HHS-OIG); and Special Agent in Charge Patrick J. Hegarty of the Department of Defense Office of Inspector General, Defense Criminal Investigative Service (DOD-OIG) made the announcement.

The FBI, HHS-OIG and DOD-OIG investigated the case.

Acting Assistant Chief Rebecca Yuan and Trial Attorney Nicholas Peone of the Justice Department’s Fraud Section are prosecuting the case.

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One of the largest hospital systems in the nation and two of its doctors will pay $37.5 million to resolve violations of the False Claims Act and the California False Claims Act. The settlement is a joint resolution with the U.S. Department of Justice and the California Department of Justice.

The United States and California entered into a settlement agreement with the Prime Healthcare Services system (Prime), Prime’s Founder and Chief Executive Officer Dr. Prem Reddy, and California interventional cardiologist Dr. Siva Arunasalam to resolve alleged violations of the False Claims Act and the California False Claims Act based on kickbacks paid by Prime to Dr. Arunasalam for patient referrals. Prime includes Prime Healthcare Services Inc., based in Ontario, California; Prime Healthcare Foundation Inc.; Prime Healthcare Management Inc.; High Desert Heart Vascular Institute (HDHVI); and Desert Valley Hospital Inc. Under the settlement agreement, Dr. Arunasalam will pay $2,000,000; Dr. Reddy paid $1,775,000; and Prime paid $33,725,000. The United States will receive $35,463,057 of the settlement proceeds, and California will receive $2,036,943. Prime and Dr. Reddy paid $65 million to settle previous unrelated allegations of false claims and overbilling in 2018.

“Offering illegal financial incentives to physicians in return for patient referrals undermines the integrity of our health care system by denying patients the independent and objective judgment of their health care professionals,” said Acting Assistant Attorney General Brian M. Boynton of the Justice Department’s Civil Division. “Today’s settlement demonstrates the department’s commitment to protect federal health care programs against such violations, as well as other efforts to defraud these important programs.”

“Doctors have a sworn duty to do no harm and to put their patients’ interests first,” said Acting U.S. Attorney Tracy L. Wilkison for the Central District of California. “Kickbacks designed to increase the number of patient referrals corrupt the doctor-patient relationship and needlessly waste this nation’s health care resources.”

“In our cities and neighborhoods, hospitals are where we go for healing and care, which means they have to be a place that the people they serve can trust,” said California Attorney General Rob Bonta. “Today’s settlement should send a message that schemes like those alleged here, that put profits before people and seek to defraud our Medi-Cal program, will not be taken lightly.”

The settlement resolves allegations that:

• Prime paid kickbacks when it overpaid to purchase Dr. Arunasalam’s physician practice and surgery center because the company wanted Dr. Arunasalam to refer patients to its Desert Valley Hospital in Victorville, California. The purchase price, which was substantially negotiated by Dr. Reddy, exceeded fair market value and was not commercially reasonable. Prime also knowingly overcompensated the doctor when HDHVI entered into an employment agreement with him that was based on the volume and value of his patient referrals to Desert Valley Hospital;
• For approximately two years between 2015 and 2017, HDHVI and Dr. Arunasalam used Dr. Arunasalam’s billing number to bill Medicare and Medi-Cal for services that were provided by Dr. George Ponce, even though they knew Dr. Ponce’s Medicare and Medi-Cal billing privileges had been revoked, and that billing Dr. Ponce’s services under Dr. Arunasalam’s billing number was improper; and
• Certain Prime hospitals billed Medi-Cal, the Federal Employees Health Benefits Program and the U.S. Department of Labor’s Office of Workers’ Compensation Programs for false claims based on inflated invoices for implantable medical hardware. Dr. Arunasalam was not implicated in this conduct.

The Anti-Kickback Statute prohibits offering, paying, soliciting or receiving remuneration to induce referrals of items or services covered by a federal health care program, such as Medicare, Medicaid or TRICARE. Claims submitted in violation of the Anti-Kickback Statute may give rise to liability under the False Claims Act.

In connection with the settlement, Prime and Dr. Reddy entered into a five-year Corporate Integrity Agreement (CIA) with the U.S. Department of Health and Human Services Office of Inspector General (HHS-OIG). The CIA requires, among other things, that Prime maintain a compliance program and hire an Independent Review Organization to review arrangements entered into by or on behalf of its subsidiaries and affiliates.

“Federal healthcare funds are integral to the provision of necessary medical services to beneficiaries across the country,” said Special Agent in Charge Timothy B. DeFrancesca of the Office of Inspector General for the U.S. Department of Health and Human Services. “Therefore, we will address any actions, including those alleged in this case, that could compromise the system on which many patients rely. We will continue working with federal and state prosecutors to guard taxpayer funds that support these vital programs.”

The civil settlement includes the resolution of claims brought under the qui tam or whistleblower provisions of the False Claims Act in two lawsuits filed in federal court in Los Angeles. One suit was filed by Martin Mansukhani, a former Prime executive. The second suit was filed by Marsha Arnold and Joseph Hill, who were formerly employed in the billing office at Shasta Regional Medical Center, a Prime hospital in Redding, California. Under the qui tam provisions of the False Claims Act, a private party can file an action on behalf of the United States and receive a portion of any recovery. Although the United States did not intervene in these cases, it continued to investigate the whistleblowers’ allegations and helped to negotiate the settlement announced today. Mr. Mansukhani will receive $9,929,656 as his share of the federal government’s recovery. The cases are United States and the State of California ex rel. Martin Mansukhani v. Prime Healthcare Services, Inc., et al., 5:18-cv-00371-RGK (C.D. Cal.); and United States and the State of California ex rel. Marsha Arnold and Joseph Hill v. Prime Healthcare Services, Inc., et al., 5:18-cv-02124-FLA (C.D. Cal.).

The resolutions obtained in these matters were the result of a coordinated effort between the Civil Division’s Commercial Litigation Branch, Fraud Section; the U.S. Attorney’s Office for the Central District of California; the California Attorney General’s Office’s Division of Medi-Cal Fraud and Elder Abuse; and HHS-OIG.

The investigation and resolution of this matter illustrate the government’s emphasis on combating health care fraud. One of the most powerful tools in this effort is the False Claims Act. Tips and complaints from all sources about potential fraud, waste, abuse and mismanagement can be reported to the Department of Health and Human Services at 800-HHS-TIPS (800-447-8477).

The cases were handled for the United States by Senior Trial Counsel Marie V. Bonkowski of the Civil Division and Assistant U.S. Attorneys Jack D. Ross and Abraham C. Meltzer of the Central District of California.  

The claims resolved by the settlement are allegations only, and there has been no determination of liability.

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Massive migrant surge expected when Title 42 ends in late May

More than 50 House Republicans Wednesday are pressing Customs and Border Protection (CBP) over the possibility it may use Veterans Affairs (VA) medical personnel to stem an expected migrant border surge.

The letter comes a little over a month before the May 23 end date for the Title 42 policy — a Trump-era public health order that allows for the expulsion of most migrants entering the U.S. because of COVID-19.

After President Biden announced earlier this month he would end the order, fears grew over a potential surge of migrants to the southern border as a result. Fox News reported shortly before Biden's announcement that CBP was considering the idea to have VA personnel assist in taking care of the migrants.

"On March 29, 2022, a CBP report indicated a surge of border crossings was imminent due to the rescinding of this authority. The report presents a dire situation that may result in as many as 18,000 possible encounters per day. If this number proves accurate, this could result in over 540,000 encounters in a single month," the GOP letter, led by Rep. Jody Hice, R-Ga., said. "Currently, CBP does not have the facilities or manpower to handle the anticipated massive surge."

The letter, addressed to Homeland Security Secretary Alejandro Mayorkas, stated that any consideration of moving VA medical personnel to the border would be "deeply troubling."

"Moving VA medical staff away from our Veteran’s healthcare needs to examine illegal immigrants is a recipe for disaster," the letter said. "Wait times for a Veteran to see their doctor can average 22 days and reach as high as 42 days. This is unacceptable mismanagement of federal government resources by the Biden administration."

Hice was joined by 53 other House Republicans on the letter, including GOP Conference Chair Elise Stefanik, R-N.Y., and Reps. Kat Cammack, R-Fla., Dan Crenshaw, R-Texas, and Andy Biggs, R-Ariz.

According to a CBP source who's worked in law enforcement for over 20 years and is familiar with the process, using personnel from the VA to assist in medical care and COVID-19 shots for migrants is not being ruled out yet.

"It does not seem to be off the table with a whole of government response" to handle the surge at the border, the source said. The source added that such an arrangement would likely be part of a "voluntary force" asking federal agencies to help respond to the surge.

A CBP spokesperson Wednesday told Fox News that it did not have any evidence such conversations were taking place but could not definitively rule it out.

A "whole of government response" could mirror a very broad strategy outlined in a March 30 press release from the Department of Homeland Security (DHS), which oversees CBP. Titled, "Preparations for a Potential Increase in Migration," DHS said in the release it would "Ready to surge personnel and resources to the Southwest Border."

"DHS has moved officers, agents, and DHS Volunteer Force personnel to rapidly decompress points along the border and more efficiently process migrants," DHS said in the press release.

It notably did not mention the VA, which is not part of DHS. The press release also said it would implement "COVID mitigation measures" including handing out PPE. But it again did not mention the possibility of VA personnel assisting in that.

"Biden's failed open border policies are no excuse to funnel resources away from our Veterans. Our men and women who put their lives on the line to protect our liberties and our country's sovereignty deserve the best resources for their health care needs," Hice said in a statement separate from the GOP letter. "The Biden Administration must provide the American people answers. Even the thought of abandoning our Veterans' care for the needs of illegal aliens is disgraceful."

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A 2017 audit found VA was routinely burying mistakes made by its medical providers.

The Senate on Thursday unanimously approved a measure that would make it harder for Veterans Affairs Department doctors disciplined for medical mistakes to get new jobs, with lawmakers in both parties saying it would bring more accountability to VA and prevent Veterans from receiving poor care.

The VA Provider Accountability Act (S. 221) would prohibit the department from agreeing to settlements with fired employees that would “conceal a serious medical error or a lapse in generally-accepted standards of clinical practice.” It would also require VA to report such adverse personnel actions to the National Practitioner Data Bank and state licensing boards.

The bill follows a 2017 Government Accountability Office report that found VA medical center officials were regularly failing to investigate complaints lodged against providers, or in some cases waiting months to do so. When the department revoked doctors’ privileges at VA medical facilities, officials failed to inform state licensing boards and rarely informed the national data bank. VA also sometimes reached settlement agreements with doctors to allow them to resign in exchange for the department withholding their mistakes from state and federal officials.

GAO said those failures could hurt Veterans and patients at non-VA facilities, citing as an example one case in which a doctor resigned from VA to avoid an “adverse privileging action”—the suspension, revocation or denial of clinical privileges—and subsequently was hired by a private hospital in the same city. Two years later, that physician received an adverse privileging action at the new hospital for the same reason the individual was forced to leave VA.

The House Veterans' Affairs Committee held a hearing on the findings, during which department officials pledged to take corrective action—including by reporting all existing adverse actions at the state and national levels. The department also said it would clarify settlement agreements that bury doctors’ mistakes were illegal. Still, lawmakers said their bill was necessary to ensure statutory change.

“VA has made attempts to correct this on their own, but I believe strict guidelines must be implemented to assure our Veterans they are receiving the highest quality of care,” Sen. Joe Manchin, D-W.Va., who co-sponsored the bill, said in February when unveiling it.

Sen. Cory Gardner, R-Colo., who introduced the legislation, said it was targeting only the small percentage of VA doctors who act inappropriately or perform poorly.

“The vast majority of VA employees and medical providers provide exceptional care to our Veterans and we are grateful for their service,” Gardner said. “However, there is no excuse for allowing certain medical providers with a history of committing major medical errors to continue putting other patients at risk. We owe every single Veteran the best possible care, and we can only provide that care with increased accountability.”

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WASHINGTON — A bipartisan group of senators on Thursday introduced a bill requiring the Department of Veterans Affairs to better Vet their health care providers after a report by a federal watchdog found the department has a track record of hiring unqualified doctors.

“Our nation’s Veterans have earned the right to the very best care, and it is outrageous that the VA is not sufficiently Vetting its health care providers,” Sen. Maggie Hassan, D-N.H., said in a statement.

The bill, which was introduced by Hassan and Sens. Joni Ernst, R-Iowa, and Kyrsten Sinema, D-Ariz., is called the Veterans Health Administration Caregiver Retention and Eligibility Determination Act. It would require the VA to improve guidance and policies on the hiring and credentialing processes and audit all providers with questionable records and determine whether those employees are still eligible for employment.

In October, Hassan, Ernst, Sinema, and Sen. Bill Cassidy, R-La., penned a letter to the VA that raised concerns about a Government Accountability Office report that found the department “overlooked or missed disqualifying information” when hiring health care providers. The senators never received a response to their letter.

“Following the VA’s failure to even respond to a letter asking how it will remedy the issues raised in the Government Accountability Office report, my colleagues and I are introducing bipartisan legislation to ensure that the VA takes action so that Veterans are not cared for by providers with a history of misconduct,” Hassan said.

The GAO reported unqualified hires were often the result in VA facilities not adhering to their hiring policies. In five health care facilities, officials weren’t aware of the policy of not hiring health care providers whose credentials have been revoked or surrendered due to incompetence or misconduct.

One example in the GAO’s report from February found was a physician who surrendered his physical-therapy license for not completing continuing education. The VA said it found no concerns with its work performance, according to the report.

In another case, the GAO found a nurse, who has been working at the VA since 2003, had her nursing license revoked in one state after not completing required training. However, the nurse continued her employment with the VA because the department found she had a license in another state. Once the GAO highlighted its concerns about medical licenses, the VA terminated five health care providers.

A VA spokeswoman said Friday that the department has not taken a position on the proposed legislation and completed an "extensive review" of all their health care providers' qualifications and license requirements in 2018, a year before the GAO issued its report. Early this year, the department said it revised decades-old policies to better assure providers meet qualification requirements.

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Memphis, TN – A Tennessee physician pleaded guilty today in the Western District of Tennessee to causing the death of one of his patients through his illegal prescribing of hydrocodone.

According to court documents, Thomas K. Ballard III, 63, of Jackson, owned and operated the Ballard Clinic, from which he issued prescriptions for dangerous, addictive controlled pharmaceutical drugs without any legitimate medical purpose. Ballard engaged in inappropriate sexual contact with several female patients while he ignored red flags that they were abusing the medications he prescribed. These abuses were often reflected in Ballard’s own medical records.

Ballard’s treatment records reflected that he believed that a particular patient had psychiatric issues, and that she was abusing her medication, fabricating personal trauma and tampering with drug screens. The records also reflected aberrant drug screens and notations about the patient’s incarceration and receipt of prescriptions elsewhere for suboxone, a drug used to treat opioid dependency disorder. In spite of that history, Ballard prescribed the patient hydrocodone repeatedly, including on May 28, 2015, when Ballard issued her the prescription for the hydrocodone on which she fatally overdosed.

"Today’s plea is a somber reminder of the human cost of illegal prescribing," said Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division. "Above all, physicians are trusted not to harm their patients. When opioid addictions are fueled at the hands of predatory prescribers, death is all too often the result. The Department of Justice and its law enforcement partners will continue to use all of the tools at our disposal to hold such prescribers accountable."

"This case represents Tennessee Bureau of Investigation Medicaid Fraud Control Division’s commitment to fighting the opioid epidemic plaguing our state, exposing fraudulent health care

schemes, and holding offenders accountable for their dishonest criminal conduct," said Special Agent-In-Charge Terry L. Reed Sr. of the Tennessee Bureau of Investigation (TBI).

"Ballard has proven himself to be nothing more than a predator in a white lab coat, and he should expect to be punished accordingly," said Special Agent in Charge J. Todd Scott of the DEA’s Louisville Division. "Doctors take an oath to first do no harm, and instead, Ballard chose to put his own licentious interests above his patients’ well-being."

"Ballard’s callous disregard for the well-being of his patients and the principles of his profession caused the death of a vulnerable woman and put other lives at risk," stated Derrick L. Jackson, Special Agent in Charge with the Department of Health and Human Services Office of Inspector General (HHS-OIG). "The damage he caused is severe and irreparable. HHS-OIG, alongside other law enforcement agencies, works to pursue medical professionals who inflict harm on patients in their care."

Ballard pleaded guilty to a count of illegal drug distribution resulting in death. He will be sentenced to 20 years in prison, the statutory mandatory minimum, on Sept. 21, if the court accepts his plea agreement. A federal district court judge will determine any non-incarceration aspect of Ballard’s sentence after considering the U.S. Sentencing Guidelines and other statutory factors.

The TBI, DEA, and HHS-OIG investigated the case.

Trial Attorneys Jason Knutson, Drew Pennebaker, and Emily Petro of the Criminal Division’s Fraud Section are prosecuting the case.

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New research from a Texas doctor has linked the onset of Gulf War illness in some Veterans to exposure to the deadly nerve gas sarin.

“Our findings prove that Gulf War illness was caused by sarin, which was released when we bombed Iraqi chemical weapons storage and production facilities,” said Dr. Robert Haley, professor of internal medicine and director of the Division of Epidemiology at the University of Texas Southwestern Medical Center. “There are still more than 100,000 Gulf War Veterans who are not getting help for this illness and our hope is that these findings will accelerate the search for better treatment.”

Haley, a medical epidemiologist who studies disease outbreaks in groups of people, has been investigating Gulf War illness for 28 years and used a genetic study that found some people have a stronger natural ability to fight the deadly chemical.

Troops who have genes that help metabolize the gas were less likely to develop the myriad of symptoms associated with the mysterious illness than those without it, according to the new research, which was released Wednesday. The findings were published in Environmental Health Perspectives, a peer-reviewed medical journal.

Following the Gulf War, which ended in 1991, returning Veterans began reporting a wide range of chronic symptoms, including fatigue, fever, night sweats, memory and concentration problems, difficulty finding words, diarrhea, sexual dysfunction and body pain. Since then, academic researchers and the Department of Veterans Affairs have been looking for the cause within the many toxic exposures that Veterans faced such as burning oil wells, pesticides, nerve gas and anti-nerve gas medication, and depleted uranium.

About 250,000 Veterans are affected by Gulf War illness, yet no cause has been widely accepted, according to the medical journal.

Sarin, which the military has confirmed as present during the war, is a toxic, synthetic nerve agent that was first developed as a pesticide. It has been used in chemical warfare and its production was banned in 1997.

When people are exposed to either the liquid or gas form, sarin enters the body through the skin or airways and attacks the nervous system. High-levels of exposure often results in death, but studies of survivors have revealed that lower-level sarin exposure can lead to long-term impairment of brain function, according to the Texas university’s research.

What causes the variety of symptoms in Veterans is the sarin exposure triggering inflammation in the brain, called chronic neuroinflammatory condition, Haley said. Knowing that, he would like to see other studies build on his research to develop treatments and cures.

“This is actually a very optimistic finding, because it’s not brain damage,” he said. “There’s nothing you can do about that.”

Haley said he first began his research on Gulf War illness at the urging of Texas billionaire and Navy Veteran Ross Perot, who funded Haley’s initial study in the early 1990s.

Even at the time, one of the strongest risk factors for those who were sick related to being in locations with increased possibility for nerve gas exposure, Haley said. The research contradicted the government’s conclusion of the time, which was the illness was caused by stress, he said.

“That set off a firestorm,” Haley said. “We were besieged for two or three weeks. Our phones didn’t stop ringing. It was incredible. Then we got some funding from the Defense Department.”

The latest research from Haley and his colleagues studied 508 Veterans who deployed and contracted Gulf War illness and 508 Veterans who deployed but did not develop any symptoms. They gauged sarin exposure by asking whether the Veterans had heard chemical nerve gas alarms sound during their deployment and by collecting blood and DNA samples from each person.

The researchers tested the samples for variants of a gene called PON1. There are two versions of PON1: the Q variant generates a blood enzyme that efficiently breaks down sarin while the R variant helps the body break down other chemicals but is not efficient at destroying sarin. Everyone carries two copies of PON1, giving them either a QQ, RR or QR genotype.

“Your risk is going up step by step depending on your genotype, because those genes are mediating how well your body inactivates sarin,” Haley said. “It doesn’t mean you can’t get Gulf War illness if you have the QQ genotype, because even the highest-level genetic protection can be overwhelmed by higher intensity exposure.”

The research doesn’t rule out that other chemical exposures could be responsible for a small number of cases of Gulf War illness. However, Haley’s team carried out additional genetic analyses on the new data, testing other factors that could be related, and found no other contributing causes.

The VA presumes disability for Veterans with certain chronic, unexplained symptoms existing for six months or more are related to Gulf War service without regard to cause, including chronic fatigue syndrome, fibromyalgia and some gastrointestinal disorders, according to the department. Those Veterans might also be eligible for other benefits including a health exam, health care and disability compensation.

Since the study was published, Haley said he’s already received letters from two Veterans asking if getting tested for the different forms of the PON1 gene and blood enzyme levels would be helpful. The test isn’t clinically available yet, but should be soon, Haley said. Then there could be some value to getting tested, but it’s more important now to seek treatment for any symptoms that they are experiencing, he said.

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Opioid Prescribing Conspiracy Allegedly Contributed to at Least Six Overdose Deaths

A federal grand jury in Kentucky returned an indictment Wednesday charging two doctors for their alleged involvement in conspiracies to illegally distribute opioids and commit health care fraud.

According to court documents, Drs. William Lawrence Siefert, 67, of Dayton, Ohio, and Timothy Ehn, 48, of Union, Kentucky, orchestrated their alleged illegal prescribing and health care fraud conspiracies through Northern Kentucky Center for Pain Relief, a pain clinic in Florence, Kentucky. Siefert, a medical doctor, was employed by the clinic, while Ehn, a chiropractor, was the clinic’s owner. Siefert and Ehn allegedly offered drug-seeking patients who should not have received opioids easy access to these dangerous controlled substances, then billed Medicaid for millions of dollars in medically unnecessary urinalysis testing related to these patients.

The indictment alleges that Siefert and Ehn’s alleged illegal opioid prescribing conspiracy was a contributing factor in the opioid overdose deaths of at least six former clinic patients.

Siefert and Ehn are each charged with one count of conspiracy to unlawfully distribute controlled substances and one count of conspiracy to commit health care fraud. Separately, Siefert was charged with three counts of health care fraud and 11 counts of illegal distribution of controlled substances, including oxycodone, hydrocodone, and clonazepam, and Ehn was charged with eight counts of health care fraud.

The announcement was made by Acting Assistant Attorney General Nicholas L. McQuaid of the Justice Department’s Criminal Division; Acting U.S. Attorney Carlton S. Shier IV of the Eastern District of Kentucky; Special Agent in Charge Keith W. Martin of the U.S. Drug Enforcement Administration’s (DEA) Detroit Field Division; Special Agent in Charge Derrick Jackson of the U.S. Department of Health and Human Services Office of Inspector General’s (HHS-OIG) Atlanta Region; Special Agent In Charge James “Robert” Brown Jr. of the FBI’s Louisville Field Office; and Executive Director W. Bryan Hubbard of the Kentucky Medicaid Fraud Control Unit (MFCU) in the Kentucky Attorney General’s Office made the announcement.

This case was investigated by the DEA’s Detroit Field Division, Cincinnati District Office Diversion Group; the FBI’s Louisville Field Office; HHS-OIG’s Louisville Field Office; and the Kentucky MFCU.

Trial Attorney Dermot Lynch and Assistant Chief Kilby Macfadden of the Criminal Division’s Fraud Section are prosecuting the case.

The Fraud Section leads the Appalachian Regional Prescription Opioid (ARPO) Strike Force. Since its inception in October 2018, the ARPO Strike Force, which operates in 10 districts, has charged 91 defendants, including 68 licensed medical professionals, and its casework has targeted the alleged illegal distribution of more than 65 million controlled substance pills involving more than 350,000 prescriptions. Since its inception in March 2007, the Health Care Fraud Strike Force, which maintains 15 strike forces operating in 24 districts, has charged more than 4,200 defendants who have collectively billed the Medicare program for approximately $19 billion. In addition, the HHS Centers for Medicare & Medicaid Services, working in conjunction with the HHS-OIG, are taking steps to increase accountability and decrease the presence of fraudulent providers.

Individuals who believe that they may be a victim in this case should visit the Fraud Section’s Victim Witness website for more information.

An indictment is merely an allegation and all defendants are presumed innocent until proven guilty beyond a reasonable doubt in a court of law.

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WASHINGTON — Two House lawmakers want the Department of Veterans Affairs to recoup bonuses paid to a pathologist in Fayetteville, Ark., who was charged with manslaughter in the deaths of three Veteran patients.

Reps. Phil Roe, R-Tenn., and Steve Womack, R-Ark., sent a letter Thursday to VA Secretary Robert Wilkie, urging him to enforce a new law that allows the VA to recover bonuses and reduce retirement pay. The law should be applied to the case of Robert Morris Levy, they argued.

Levy, the longtime chief pathologist at the Veterans Health Care System of the Ozarks, was charged by federal prosecutors in August 2019 with the deaths of three Veterans and a scheme to cover up years of abusing substances on the job. During his years as chief pathologist, he misread samples of ill patients and made thousands of misdiagnoses. He was fired from the VA in 2018 for being impaired during work hours.

Earlier this month, Levy pleaded guilty in federal court to two of 31 counts against him – one count of involuntary manslaughter and one count of mail fraud. The crimes carry a maximum sentence of 28 years in prison.

While working for the VA, Levy made an annual salary of $225,000. According to the indictment, he received bonuses that were based on his error rates as chief pathologist – rates he manipulated.

"It is unfathomable that he would continue to retain bonuses that were earned through misrepresentation and collect a full taxpayer funded pension while facing 28 years in prison for crimes he committed on the job,” Roe said in a statement. “I am… calling on Secretary Wilkie to conduct a full accountability review to determine whether VA can recoup pension and unearned bonuses from Dr. Levy.”

Congress passed legislation in 2017 that allows the VA secretary to fire, demote and suspend employees quickly. The VA Accountability and Whistleblower Protection Act also allows the agency to recoup bonuses if employees performed poorly on the job.

VA Press Secretary Christina Noel said Friday that the law only applies to bonuses paid after June 23, 2017, the date the law went into effect.

The VA is reviewing Levy's personnel records to see whether there are any applicable bonuses that the department could recoup, she said.

Roe and Womack also questioned whether he was eligible for retirement pay. If he is, the lawmakers asked whether it could be reduced.

“My fellow Arkansans and I demand full accountability and justice,” Womack said.

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Two doctors who helped a local hospice agency scam Medicare were sentenced today to a combined 23 years in prison for healthcare fraud, announced U.S. Attorney for the Northern District of Texas Chad E. Meacham.

In May, a federal jury found Novus Health Services Medical Directors Dr. Mark E. Gibbs and Dr. Laila Hirjee, along with Novus RN Tammie Little, guilty of conspiracy to commit healthcare fraud and other charges. Today, Chief U.S. District Judge Barbara M.G. Lynn sentenced Dr. Gibbs to 13 years in federal prison and ordered him to pay $27,978,903 in restitution; she sentenced Dr. Hirjee to 10 years in federal prison and ordered her to pay $16,253,281 in restitution. The judge also sentenced Ms. Little to 33 months in federal prison.

According to evidence presented at trial, the defendants helped Novus CEO Bradley Harris defraud Medicare by, among other things, illegally admitting patients who were not appropriate for hospice and submitting materially false claims for hospice services.

Mr. Harris, who pleaded guilty prior to trial, testified against his former employees.

He told the jury that instead of relying on the expertise of licensed medical professions, he and Novus nurses determined which patients would be admitted to or discharged from hospice care, as well as which drugs and dosages they would receive.

They relied upon Novus doctors, including Dr. Gibbs and Dr. Hirjee, to certify that they had examined these patients face-to-face, when no such examinations had occurred, Mr. Harris testified.

Witnesses also testified that Dr. Hirjee and Dr. Gibbs engaged in the prescription of Schedule II controlled substances, such as morphine, hydromorphone, and fentanyl, by pre-signing blank C2 prescriptions and giving those to Brad Harris and others at Novus to let them prescribe controlled substances without any physician oversight.

As Director of Operations Melanie Murphey testified on day five of trial, “I was the doctor.”

Mr. Harris and the nurses used pre-signed prescription pads, prepared by Dr. Gibbs, Dr. Hirjee, and other Novus doctors, to dispense medications like morphine to patients. When Medicare suspended payment to Novus over concerns about billing, Mr. Harris, Dr. Gibbs, and others moved patients and employees to a new hospice company and continued to bill Medicare for hospice services.

In total, Medicare and Medicaid paid the Novus entities approximately $40 million dollars for hospice services before the companies were shut down.

“These doctors allowed Bradley Harris – an accountant with no medical expertise – to dispense controlled substances like candy, with little to no medical oversight,” said U.S. Attorney Chad Meacham. “They claimed to have had hands-on experience with hospice patients, when in fact, they’d entrusted life-or-death medical decisions to untrained businesspeople. We are satisfied to know they will spend the next decade behind bars.”

“The defendants violated their Hippocratic Oath as doctors and instead focused on lining their pockets at the expense of patient safety. This case highlights the importance of thoroughly investigating any complaint of healthcare fraud,” said FBI Dallas Special Agent in Charge Matthew DeSarno. “We encourage the public to help us identify, investigate, and prosecute this crime. If you suspect health care fraud, report it to the FBI at tips.fbi.gov, 1-800-CALL-FBI, or contact your health insurance provider.”

Several of their codefendants – Novus CEO Brad Harris, his wife, Novus Vice President of Patient Services Amy Harris, Novus Director of Operations Melanie Murphy, Novus Medical Director Charles Leach, Novus Medical Director Reziuddin Siddique (deceased), Novus Vice President of Marketing Samuel Anderson, Novus Director of Marketing Slade Brown, Novus RN Jessica Love, Novus triage RN Patricia Armstrong, Novus LVN Taryn Stewart, and Ali Rizvi, the owner of a separate physician home visit company – pleaded guilty to various offenses prior to trial. Love was sentenced 102 months, Stuart was sentenced to 96 months, Armstrong was sentenced to 84 months, Dr. Leach was sentenced to 57 months, and Anderson was sentenced to 33 months. The remaining defendants are facing statutory maximums of between two and 14 years in federal prison.

The Federal Bureau of Investigation’s Dallas Field Office, the U.S. Department of Health & Human Services Office of Inspector General (HHS-OIG), and the Texas Attorney General’s Medicaid Fraud Control Unit conducted the investigation. Assistant U.S. Attorneys Donna Strittmatter Max and Marty Basu are prosecuting the case with Assistant U.S. Attorneys Stephen Gilstrap, Gail Hayworth, and Brian McKay.

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Lawmakers are demanding reforms in how Veterans Affairs officials screen outside doctors for patient medical care after a recent Government Accountability Office review found the department’s referral list contains about 1,600 providers that are ineligible to treat Veterans, including 601 who are dead.

“While [the list] represents a small percentage of the Veterans Community Care Program’s roughly 1.2 million active providers, they represent potential threats to Veteran health and safety and risks for financial fraud,” a group of representatives wrote in a letter to VA health officials on Friday.

“We urge VA to review all ineligible providers identified by GAO and, as appropriate, deactivate them in the Community Care Network so Veterans are not referred to them for care.”

The request — signed by Reps. Chris Pappas, D-N.H.; Tracey Mann, R-Kansas; Julia Brownley, D-Calif.; and Jack Bergman, R-Mich. — comes amid increasing scrutiny of VA’s Community Care program, which allows Veterans to receive care from private-sector physicians but have the appointments paid for with taxpayer money.

The program has been a key part of VA health care for decades, but conservatives in recent years have pushed to expand it dramatically amid concerns of long wait times and specialist shortages at some VA medical centers.

But critics of that plan have said that department officials need to improve their oversight of Community Care providers first, to make sure they are meeting the same medical standards and expectations of VA physicians.

The latest GAO review appears to bolster that argument, noting that VA officials had failed to exclude a small but significant number of ineligible providers from the Community Care program.

Along with 601 deceased physicians, the list included 216 active providers who had a revoked medical license and 796 who have surrendered their medical licenses in response to an investigation.

One provider had a nursing license expire in 2016, was arrested for assault in 2018, and convicted of patient abuse in 2019. The individual was still added to the Community Care list later in 2019, a move that VA officials have now said was a clerical error.

“The vulnerabilities we identified … indicate that Veterans may potentially be at risk of receiving care from unqualified providers,” the GAO report states.

The researchers offered 10 recommendations for reforms, to include monthly checks of all outside provider credentials to look for any concerning activity and better fraud control safeguards for the current application system.

VA officials in response said that they will enact reforms in coming months, with improvements in the periodic checks of provider credentials to start next month.

The lawmakers — all members of the House Veterans’ Affairs Committee — requested a report from the department on that progress by the end of February.

The full report is available on the GAO web site.

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A Department of Veterans Affairs hospital in Richmond, Virginia, rehired a pathologist who had been previously fired for failing to diagnose or misdiagnosing cancer in at least a dozen patients, the VA Office of Inspector General reported Wednesday.

None of the incidents were reported as adverse events to patient safety officials at the facility, the Hunter Holmes McGuire VA Medical Center, including one involving a patient whose misdiagnosis caused their condition to worsen, later requiring advanced medical treatment.

The report is the second in two days from the VA OIG to expose physician failures at VA hospitals that went unchecked by administrators. On Tuesday, the VA OIG released a report finding that the department took nine months to fire an emergency room contract physician who, after deciding a patient was "malingering" and "ranting," called VA police to have the patient escorted off property and said they could go "shoot [themselves]. I do not care."

The veteran died by suicide six days later from a self-inflicted gunshot wound.

In 2017, the Government Accountability Office reported that VA medical center officials regularly failed to investigate complaints lodged against providers or waited months to look into allegations.

The report also found that when the VA revoked doctors' privileges, officials often failed to inform state licensing boards or a national database, allowing the doctors to practice elsewhere. The VA also sometimes reached settlements with physicians that allowed them to resign in exchange for not reporting their errors.

In subsequent congressional hearings on the issue, VA officials pledged to address the problems, including reporting adverse actions at the state and national levels.

But the OIG report released Wednesday indicates that hospital officials continue to engage in cover-ups.

According to the report, the hospital's Pathology and Laboratory Medicine Services chief wasn't even aware of the VA's requirement to report the misdiagnoses to higher-ups. Senior officials also weren't aware they were supposed to participate in a state licensing review board process following the incidents.

The physician was fired but appealed the termination. In March 2019, the doctor was rehired, and clinical privileges were restored. As of last September, the physician continued to work at Hunter Holmes McGuire as an investigation was ongoing into his or her ability to turn around surgical readings in a timely manner.

Likewise, at the Washington, D.C., VA Medical Center, officials failed to dismiss the physician, a contractor, who verbally abused the suicidal veteran even though other employees reported the incident and the doctor had been the subject of other reports of "verbal misconduct."

The report noted that the doctor remained as a physician at the VA because reviews found his or her care of patients to be sufficient.

The Washington, D.C., VA eventually ended the physician's contract, according to the report.

President Donald Trump frequently touts changes that his administration has made to "fix" the VA, including accountability legislation approved in 2017 that accelerated the process for firing workers for misconduct or poor performance, as well as shortening the time employees have for processing appeals.

"I signed the VA Accountability Act into law, and we've removed more than 9,000 VA workers who were not giving our veterans the care, respect, attention that they've earned. And now that we have accountability -- it's 'accountability;' a very nice word -- if an employee of the government mistreats our veterans in any way, does something wrong, isn't good for the VA, the secretary looks at them and says, "You're fired. Get out," Trump said in a speech June 17 to introduce his plan for reducing veteran suicides.

The OIG reports this week, however, indicate that the VA still struggles to hold physicians accountable and to protect veteran patients or the public, in cases of physicians who go on to practice at civilian facilities after leaving the department.

In Richmond, VA officials failed to conduct a state licensing board review and in Washington, D.C., the doctor was never reported to the state and national boards that record physician misconduct.

"Facility leaders did not report [the Washington, D.C.] physician to the State Licensing Board or National Practitioner Data Bank. Although facility leaders did not conduct a formal investigation, they removed [the physician] from the VA contract... and therefore, facility leaders had a duty to report," the VA OIG wrote.

"Neither the former Facility Director nor the Chief of Staff completed all elements of a [VA]-required review upon discovery of the subject pathologist's 'egregious performance,'" the VA OIG wrote.

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WASHINGTON — The Department of Veterans Affairs failed to thoroughly Vet medical providers for its community care program, resulting in doctors with revoked or suspended medical licenses being approved to treat Veterans, according to a new report from the Government Accountability Office.

The GAO investigated the VA’s community care program, which sends Veterans to private-sector doctors in certain situations. When Vetting doctors to allow them into the program, the VA was “cutting corners,” the investigation found. The GAO identified 1,600 providers who were ineligible for the program under the VA’s policies but had been accepted into it.

In some cases, the doctors had criminal records or had previously committed health-care fraud.

“Our work … basically found that they were really cutting corners,” said Seto Bagdoyan, director of audits at GAO. “They were not performing monthly checks, for example. And even when they did flag someone as ineligible, that individual… was not removed in a timely manner.”

In one instance, the VA approved a doctor who had been convicted of patient abuse and neglect. The doctor also had an expired medical license, had been arrested for assault and had been excluded from participating in other federal health-care programs.

Another doctor who was accepted into the program had a revoked medical license and posed a “clear and immediate danger to public health and safety,” the GAO reported.

“This individual was somehow deemed eligible for referrals in the program,” Bagdoyan said. “Both of these examples help illustrate that having ineligible providers poses a risk to Veterans’ health.”

The VA refers Veterans to community care in certain cases, including when they must wait longer than 20 days for an appointment or drive more than 30 minutes to reach their VA health-care provider. The program expanded under the VA Mission Act, a measure approved in 2018.

During its investigation, the GAO assessed 800,000 of the approximately 1.2 million providers involved in the community care program. Of the 800,000, the watchdog found 1,600, or 0.2%, shouldn’t have been approved.

The GAO recommended the VA follow its own regulations for community care doctors “without cutting corners.” It also suggested the VA improve its systems to automatically flag providers who don’t meet the criteria for the program.

The VA agreed to implement all the recommendations this year. Bagdoyan said the department was “eager” to review the providers flagged by the GAO.

After the GAO’s findings were released Thursday, four lawmakers on the House Committee on Veterans’ Affairs wrote to Steven Lieberman, deputy to the VA undersecretary for health, urging him to review and deactivate the 1,600 providers.

Reps. Chris Pappas, D-N.H., Tracey Mann, R-Kan., Julia Brownley, D-Calif., and Jack Bergman, R-Mich., signed the letter. They asked the VA to update them by Feb. 28 about the actions taken.

“This put Veterans at risk of receiving care from unqualified providers, and it put [the Veterans Health Administration] at risk of making payments to fraudulent providers,” the lawmakers wrote.

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VA Secretary Denis McDonough said he would consult the future under secretary for health on how to handle the rising cost of private sector care.

The Department of Veterans Affairs may alter the rules for its community health care program, a system designed to help Veterans see doctors outside of the VA system if they don’t have easy access to a VA medical facility, to stop that program’s growing spending from devouring its overall health care budget, according to VA Secretary Denis McDonough.

During a Senate hearing on the VA budget Tuesday, McDonough said the community care program now accounts for 33% of the VA's total health care demand, up from roughly 26% last year.

McDonough warned lawmakers last year that the growth was not sustainable, but said Tuesday he would consult with his new under secretary for health before formally proposing the move.

"[33% is] a high number, and that's the highest number yet of the three years of the Mission Act. Care overall, as you have seen in the budget, is growing. Care in the community as a portion of that is growing... My hunch is that we should change access standards," McDonough said.

The 2018 VA Mission Act overhauled the department's private-sector health care programs for Veterans, consolidating a number of civilian-care programs into a single community care program available to more Veterans, with the costs covered by the department.

Under at least one of its predecessor programs, VA Choice, Veterans were only eligible for community care if they lived more than 40 linear miles from a VA medical facility or were unable to get an appointment within 30 days.

But the Mission Act expanded the standards to include Veterans who face drive times of at least 30 minutes to a primary or mental health appointment or 60 minutes for specialty care, or those who must wait 20 days or more to be seen for primary care or 28 days for specialty care.

McDonough said he would consult his new under secretary for health, Dr. Shereef Elnahal, once he is confirmed by the Senate as to whether changes are necessary.

"I'm not going to hoist him with my views. He happens to be a health care professional so we should probably have his views on this," McDonough said.

Kansas Sen. Jerry Moran, the committee's ranking Republican, introduced a bill last July that would give Congress the authority to determine eligibility thresholds for community care.

During Elnahal's confirmation hearing, Moran asked Elnahal what he thought of the access standards, which Moran described as "reasonable" and a "concrete measure" on which Veterans "can rely in terms of accessing care."

"Wait time calculation, the access standard regulations I think are very clear," Moran said on April 27.

The Senate was to vote on Elnahal's nomination on May 25, but what was expected to be a swift approval was blocked by Sen. Rick Scott, R-Fla., who said he objected to what he said was President Joe Biden's failure to "appoint qualified individuals to serve in important roles."

Scott did not cite Elnahal specifically or detail why he thought Elnahal, a former Veterans Affairs assistant deputy under secretary for health and chief executive officer of University Hospital in Newark, New Jersey, was unqualified.

The VA has not had a permanent under secretary for health since 2017, when Dr. David Shulkin, who had held the position since 2015, was nominated to be VA secretary.

In the three years since the Mission Act has been in effect, Veterans have reported that they encounter problems getting referrals to community care. The decision to refer is supposed to be determined by a Veteran and their doctor, but Veterans have said that their requests are often denied by VA employees who are not members of their health teams.

An investigation by inewsource and USA Today in November found that VA administrators have overruled doctors' referral recommendations to ensure that patients stay in the VA direct care system.

McDonough addressed the investigation during a hearing in December, saying the findings were not true.

"To suggest that by design we're breaking the law is an overstatement," McDonough said.

Nonetheless, McDonough said VA must do something to ensure that the community care budget does not continue expanding at its current rate. The VA's $301 billion fiscal 2023 budget request includes $99.1 billion for medical services, including $28.5 billion for community care, according to budget documents.

"What we know is demand for health care over the course of the Mission Act has increased. It has increased more intensively for care in the community," McDonough said.

McDonough said the department would seek input from Congress and the public using the federal regulatory process before changing the standards.

The House Appropriations kicks off deliberations on the VA funding bill Wednesday. The Senate Appropriations Committee has not released a timeline for introducing its version of the bill.

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Bronx VA psychiatrist-researcher cited for work in suicide prevention

Project Life Force helps Veterans cope with suicidal urges

“You often hear negative news about the VA, specifically related to suicide. We don’t recognize the hard work and achievements of our providers, which is why I wanted to honor Dr. Goodman. Sometimes we need to recognize good work in the news.”

Those are the words of Iraq combat Veteran Wilfredo Santos, a patient at the James J. Peters VA Medical Center in the Bronx, New York. He took it upon himself to arrange for formal honors for a VA clinician he credits with saving his life.

The life-saving work took place not in an emergency room or surgery suite, but in classrooms at the Bronx VA where groups of Veterans—including Santos—meet on a regular basis. They talk about their problems, their challenges and their experiences in wanting to take their own lives. The idea of the program is to bring together Vets who have a recent history of suicidal thinking or behavior and provide them with group psychotherapy. They use peer support and revise their safety plans as they add the skills they are learning.

The format, known as Project Life Force, was spearheaded by Dr. Marianne Goodman. She’s the associate director of the New York Mental Illness Research, Education and Clinical Center (MIRECC), based at the Bronx VA. She is also a professor of psychiatry at the Icahn School of Medicine at Mount Sinai.

Project being expanded to other VA sites

The model she pioneered has been expanded to a few other VA sites so far—Kansas City, Albany and Syracuse. It is being tested in a VA-funded randomized clinical trial at the Bronx and Philadelphia VA medical centers. The study will include 265 Veterans.

With the help of Santos’ congressman, Rep. Jose Serrano, a flag flew over the U.S. Capitol in Goodman’s honor on June 1. Goodman received the flag in a ceremony at the Bronx VA in August.

Santos, an Army mechanic who deployed to Iraq during 2008 and 2009, says Project Life Force has been a life-saver for him and his peers.

“We communicate with other Veterans in the room to offer support and generate ideas on how to distract yourself so you don’t hurt yourself. We truly use our suicide safety plans and make them part of our everyday lives.”

Veterans in suicide support group feel someone understands

Group sessions for Veterans with issues like PTSD or anger are common in VA, but Goodman has been breaking new ground by running groups for suicidal Veterans. Some experts fear that having suicidal patients mix and share their thoughts and feelings could actually increase risk. Goodman and her team have found otherwise. She says the very power of the intervention appears to be the group.

“Veterans no longer feel alone,” she says. “They feel someone understands their impulses and urges.”

As for the flag honor that Santos initiated, Goodman takes it as a sign of the impact of Project Life Force: “The flag and the dedication on Capitol Hill are an incredible honor. It’s a great feeling to know that our work is helping Veterans find meaning and purpose in their lives.”

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When U.S. Army Veteran Daniel Wilkinson started feeling sick last week, he went to the hospital in Bellville, Texas, outside Houston. His health problem wasn't related to COVID-19, but Wilkinson needed advanced care, and with the coronavirus filling up intensive care beds, he couldn't get it in time to save his life.

"He loved his country," his mother, Michelle Puget, told "CBS This Morning" lead national correspondent David Begnaud. "He served two deployments in Afghanistan, came home with a Purple Heart, and it was a gallstone that took him out."

Last Saturday, Wilkinson's mother rushed him to Bellville Medical Center, just three doors down from their home.

But for Wilkinson, help was still too far away.

Belville emergency room physician Dr. Hasan Kakli treated Wilkinson, and discovered that he had gallstone pancreatitis, something the Belville hospital wasn't equipped to treat.

"I do labs on him, I get labs, and the labs come back, and I'm at the computer, and I have one of those 'Oh, crap' moments. If that stone doesn't spontaneously come out and doesn't resolve itself, that fluid just builds up, backs up into the liver, backs up into the pancreas, and starts to shut down those organs. His bloodwork even showed that his kidneys were shutting down."

Kakli told Begnaud that his patient was dying right in front of him. Wilkinson needed a higher level of care, but with hospitals across Texas and much of the South overwhelmed with COVID patients, there was no place for him.

Kakli recalled making multiple phone calls to other facilities, only to get a lot of, "sorry … sorry … sorry," in reply. Places had the specialists to do the procedure, but because of how sick he was Wilkinson needed intensive care, and they didn't have an ICU bed to put him in.

"Then I'm at my computer and, I'm just like, scratching my head, and I get this thought in my head: I'm like, 'What if I put this on Facebook or something, maybe somebody can help out?' One doctor messaged me: 'Hey, I'm in Missouri. Last time I checked, we have ICU beds. We can do this, call this number.' The next guy messages me, he's a GI specialist, he goes, 'I'm in Austin. I can do his procedure, get him over.' I said, 'Okay great, let's go.' He texts me back five minutes later: 'I'm sorry. I can't get administrative approval to accept him, we're full.'"

For nearly seven hours Wilkinson waited in an ER bed at Belville.

"I had that thought in my head: 'I need to get his mother here right now,'" Kakli said. "I said, 'If he doesn't get this procedure done, he is going to die.'

"I also had to have the discussion with him. ''Dan,' I said, 'if your heart stops in front of me right here, what do you want me to do? Do you want me to do everything we can to resuscitate you and try and get your heart back? If that were to happen, Dan, if I were to get you back, we're still in that position we're in right now.'"

"He said, 'I want to talk to my mom about that,'" Kakli told CBS News.

Finally, a bed opened up at the V.A. hospital in Houston. It was a helicopter ride away.

Kakli recalled Wilkinson saying, "Oh, man, I promised myself after Afghanistan I would never be in a helicopter again! … Oh, well, I guess."

Wilkinson was airlifted to Houston, but it was too late.

"They weren't able to do the procedure on him because it had been too long," his mother told Begnaud. "They] told me that they had seen air pockets in his intestines, which means that they were already starting to die off. They told me that I had to make a decision, and I knew how Danny felt; he didn't want to be that way. And, so, we were all in agreement that we had to let him go."

Roughly 24 hours after he walked into the emergency room, Daniel Wilkinson died at the age of 46.

Kakli told Begnaud that if it weren't for the COVID crisis, the procedure for Wilkinson would have taken 30 minutes, and he'd have been back out the door.

"I've never lost a patient from this diagnosis, ever," Kakli said. "We know what needs to be done and we know how to treat it, and we get them to where they need to go. I'm scared that the next patient that I see is someone that I can't get to where they need to get to go.

"We are playing musical chairs, with 100 people and 10 chairs," he said. "When the music stops, what happens? People from all over the world come to Houston to get medical care and, right now, Houston can't take care of patients from the next town over. That's the reality."

As of last night, there were 102 people waiting for an ICU bed in the greater Houston area.

Harris County Judge Lina Hidalgo told Begnaud that she was prepared to open a field hospital, but as of Friday morning, hospitals in the Houston area were telling her they had extra beds — but not enough nurses. Seven hundred nurses arrived last week, but it's still not enough to meet the demand.

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