USA Today has dropped another article on the Department of Veterans Affairs (VA) as the publication continues its investigation into the department. This investigation discovered that a VA policy has allowed hospitals to hire health care providers with revoked licenses, but it’s illegal to do so thanks to a 1999 law:

The VA issued national guidelines in 2002 giving local hospitals discretion to hire clinicians after “prior consideration of all relevant facts surrounding” any revocations and as long as they still had a license in one state.

But a federal law passed in 1999 bars the VA from employing any health care worker whose license has been yanked by any state.

Hospital officials at the VA in Iowa City, Iowa, relied on the illegal guidance earlier this year to hire neurosurgeon John Henry Schneider, who had revealed in his application that he had numerous malpractice claims and settlements and Wyoming had revoked his license after a patient death. He still had a license in Montana.

VA Secretary David Shulkin has started to change the process by ordering people to rewrite guidelines and has “launchd a nationwide review to identify and remove any other health care workers with revoked licenses.” From USA Today:

“It’s very clear to me that our job is to have the best quality doctors that we can provide to take care of veterans, and that’s going to be our policy,” he said.

Shulkin said health care providers with prior sanctions against their medical licenses short of revocation — suspensions or reprimands, for example — also will be reviewed to ensure they are providing quality care to veterans at the VA.

USA Today previously detailed the not so thorough hiring process (emphasis mine):

Applications are vetted, education and licenses verified, references checked, and interviews conducted. For clinical hires, a review and approval by a professional standards board also is required.

But when applicants disclose prior problems with medical licensing short of revocation, malpractice or criminal histories, VA hospital officials have discretion to weigh the providers’ explanations and approve their hiring anyway.

There’s another reason why those with shady pasts find the VA so welcoming:

Agency clinicians aren’t required to have malpractice insurance — the federal government pays out claims using taxpayer dollars — making the VA a good fit for providers who may have difficulties securing malpractice insurance in the private sector if past issues have rendered them too risky.

Doctors With Malpractice Claims, Felony Convictions

This all stems from the USA Today report earlier this month about VA hospitals hiring health care doctors that have malpractice claims and felony convictions. The publication listed numerous instances, but neurosurgeon John Henry Schneider really stuck out. Montana and Wyoming had already revoked his license:

Neurosurgeon John Henry Schneider racked up more than a dozen malpractice claims and settlements in two states, including cases alleging he made surgical mistakes that left patients maimed, paralyzed or dead.

He was accused of costing one patient bladder and bowel control after placing spinal screws incorrectly, he allegedly left another paralyzed from the waist down after placing a device improperly in his spinal canal. The state of Wyoming revoked his medical license after another surgical patient died.

Thing is, Schneider didn’t change his ways when the VA in Iowa City, IA hired him:

He started work in April at a hospital that serves 184,000 veterans in 50 counties in Iowa, Illinois and Missouri.

Some of his patients already have suffered complications. Schneider performed four brain surgeries in a span of four weeks on one 65-year-old veteran who died in August, according to interviews with Schneider and family members. He has performed three spine surgeries on a 77-year-old Army veteran since July — the last two to try and clean up a lumbar infection from the first, the patient said.

James Wehmeyer had an operation on his spine over the the summer, but Schneider had to perform two more surgeries due to infections. He had his last surgery last month, but still has a gaping wound that a nurse has to clean out every three days.

USA Today reported that “three other patients suffered infections after procedures Schneider conducted at the Iowa City VA – two deep-wound and one superficial – but they were cured with antibiotics.”

The paper spoke to the daughter of Joseph Hopkins, 65, who passed away in August due to an infection after four surgeries that Schneider performed in four weeks:

Hopkins’ daughter Amy McIntire told USA TODAY this week that she is furious Schneider was hired in the first place and floored by the national policy that allowed it.

“I’m appalled by the ineptitude at the VA,” said McIntire, a registered nurse who noted that an agency so large has numerous staff to write policies and ensure they comply with federal law. “For it just to be ignored, it’s crazy.”

Outrage From Congress

After USA Today‘s report earlier this month, members in Congress started to ask questions and demand answers, especially those from Iowa. Republican Senators Joni Ernst and Chuck Grassley from Iowa sent a joint letter to the VA for some answers about the hiring practice at the facility that employed Schneider:

The investigation, which the senators described as disturbing, reported that neurosurgeon John Henry Schneider — who racked up more than a dozen malpractice claims and settlements in two states — was hired by the Department of Veterans Affairs hospital in Iowa City after he was forthright in his application about his license revocation in Wyoming.

“It should go without saying that physicians hired by the VA should be fit to practice and have a track record of providing quality care,” the senators wrote in the letter.

After USA TODAY’s investigation, VA officials determined Schneider’s hiring — and potentially that of an unknown number of other doctors — was illegal. The senators called that unacceptable and asked the VA what actions it would take to determine if other doctors were hired illegally.

The story has rightfully angered lawmakers from all states. Fourteen senators sent a letter similar to the one from Ernst and Grassley:

Fourteen senators signed the letter, which asks VA Secretary David Shulkin why the agency hired doctors with known conduct and performance issues, some of which resulted in sanctions and criminal charges.

“For years, states have experienced provider shortages across many different medical specialties, and like the private sector healthcare industry, the VA has faced similar provider shortages,” the senators wrote. “As such, we request information about the VA’s oversight of provider hiring guidelines to ensure that the pressure to fill shortages has not led to insufficient health care quality controls.”

The Dec. 8 letter also calls for the VA to review all medical providers in each of the agency’s clinics and hospitals and identify those who were hired despite problems that have led to sanctions, claims or criminal charges.

Thirty-one representatives sent their own letter to the VA:

On Monday, 31 members of the U.S. House of Representatives fired off letters to the VA secretary expressing “extreme concern.”

“The hiring of doctors who have had their medical licenses revoked in any state is already prohibited,” 30 of the lawmakers wrote, including Democratic and Republican members of the House Veterans Affairs Committee. “However, it appears the laws and regulations establishing that prohibition are not being followed by VA.”