Healthcare Inspection Alleged Issues in Fee Basis Care Martinsburg VA Medical Center Martinsburg, West Virginia

The purpose of this review was to determine the validity of an allegation that the Interim Chief of Staff (COS) denied Fee Basis Service (FB) consults because of cost at the Martinsburg VA Medical Center (medical center), Martinsburg, WV. We did not substantiate the allegation. However, during our review, we identified a process needing improvement. We found from interviews that primary care providers (PCPs) and other staff were not aware of the revised medical center FB policy and guidelines. Although the Interim COS made and documented FB care decisions based on VHA policy, we did not find evidence that the Interim COS discussed the cases with the PCPs. As a result, staff developed misperceptions that the Interim COS denied FB services for the benefit of cost savings. We recommended that staff receive communication or education on the medical center’s process for FB approval.