Healthcare Inspection - Improper Procurement and Billing Practices for Anesthesiology Services, George E. Wahlen VA Healthcare System, Salt Lake City, Utah

The VA Office of Inspector General Office of Healthcare Inspections conducted an inspection in response to allegations about improper procurement of and billing practices for anesthesiology services provided by an affiliated school of medicine, the University of Utah School of Medicine (U of Utah), at the George E. Wahlen VA Salt Lake City Health Care System (VASLCHCS), Salt Lake City, UT. We substantiated the allegation that, until April 2011, there had been no formal negotiated contracts for anesthesiology services between VASLCHCS and U of Utah since 2002; VASLCHCS was paying for services performed at the VA facility through the use of purchase orders. We substantiated the allegation that U of Utah billed VASLCHCS for work performed by an anesthesiologist employed by VASLCHCS. We substantiated the allegation that VASLCHCS was billed at unsupported rates as set forth in VA Directive 1663 for medical services performed by U of Utah anesthesiologists. We recommended that the Under Secretary for Health develop and implement a plan of action to ensure that procedures described in VA Directive 1663 are followed when purchasing medical services from VA affiliated academic institutions and prohibit the use of purchase orders to obtain contract provider services unless the purchase orders contain required clauses.