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Report: Military needs to do better job ensuring medical providers are qualified

The Government Accountability Office says not all medical licenses were reviewed before doctors were granted privileges to treat patients.

WASHINGTON — The military health system is among the nation's largest and most complex, responsible for providing care through military hospitals and clinics and the private sector to approximately 9.6 million beneficiaries, including uniformed service members, military retirees, and their families.

The Defense Health Agency is in charge of administering the DOD's medical facilities but according to the Government Accountability Office, the agency didn't always adhere to its own clinical quality management procedures, such as reviewing patient safety events -- which harmed or could have harmed patients -- within the required timeframes.

Another big area of concern involved credentialing, which is the process of verifying that a medical provider has the appropriate qualifications and abilities to deliver specific health care services.

The GAO found that for about one-sixth of providers reviewed, the facilities did not verify all medical licenses before granting privileges.

"We reviewed 10 different credentialing procedures and found cases of non-adherence across all of those," said Sharon Silas, a director in the GAO's health care team.

She continued: "For example, we found that the facility staff, when they were doing the credentialing review, they didn't always verify that providers' licenses were valid."

The GAO recommends that the Defense Health Agency clarifies its clinical quality management procedures and conducts monitoring to ensure that facilities adhere to the procedures. The DOD concurred with both recommendations.

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