Tuberville Discusses Medication Management for Veterans at Senate VA Hearing

WASHINGTON - U.S. Senator Tommy Tuberville (R-AL) discussed best practices for medication management for veterans during a Senate Veterans' Affairs (SVAC) Committee hearing. Panelists included Alyssa Hundrup, Director for the Government Accountability Office's Health Care team; Julie Kroviak, Principal Deputy Assistant Inspector General and Acting Assistant Inspector General for Healthcare Inspections at the U.S. Department of Veterans Affairs; and Erin Fletcher, Warrior Care Network Director for the Wounded Warrior Project.

During the conversation with the panelists, Senator Tuberville discussed ways to prevent medical professionals from overprescribing harmful medications to veterans and how to improve access for alternative forms of treatment such as Hyperbaric Oxygen Treatment (HBOT), of which Senator Tuberville has been a strong advocate for during his time in the Senate.

Excerpts from Senator Tuberville's remarks can be found below or viewed on YouTube or Rumble.

TUBERVILLE: "Thank you, Mr. Chairman. Thanks for being here. Good to see you all. Very important issue. We have a lot of problems in my state of Alabama with overprescribing at times. Doctor, you and Ms. Hundrup spoke about enhancing oversight at the VA and medical-management-related issues, especially a better hold on medical professionals accountable for overprescribing harmful medications. Do we have a plan for that? Both of you-could y'all answer?"

DR. KROVIAK:"So, ultimately, the plan is VAs, but what our oversight work has shown that a lot of critical leaders in the VISN, which is a body that exists to oversee the facilities, do not have defined roles and responsibilities and clear lines of authority. So, VA has a plethora of directives and policies that are based in evidence. However, it's the consistent application of those policies and practices where we find most of the issues that we report on. With structured oversight roles within the VISN where leaders know what is their responsibility-it is written down and they own it, and that certain staff and procedures and practices are they are accountable to that leader can really help enforce. We feel it could really help enforce the more consistent application of these directives and policies and practices that they have plenty of."

TUBERVILLE: Thank you. Miss?

HUNDRUP: "I would also again echo Dr. Kroviak. We have many similar findings and share the same sentiments, but I would just add that in our work, I think by having VA more clearly document the treatment plans that are in a mental health care plan and have them be easily identifiable as well as document that what evidence-based treatment options were considered. Obviously, in many, many cases, it's very complex. There's not a straightforward answer. There does have to be adjustments very specific to the individual that change over time. And these are complex cases, so you might have multiple medications involved. But by having that documented and clear in the record, it sets up VA to be in a position to monitor that and they had committed to reviewing individual provider's plans-a sample of plans-on an annual basis just to make sure-I think as Dr. Kroviak said-some of these, the policies are only as good as they're implemented. So, I would be interested to see what VA is doing to continue to monitor and look for outliers and then take action with providers that may not have the best education or may not be making the best decisions for their veterans."

TUBERVILLE: "Do y'all think we should have oversight on foreign-manufactured drugs that we give our veterans. Is there any thought on that?"

FLETCHER: "I think - thank you for that question-I think we're - where Warrior Project would stand on this, is we want our veterans to be as informed as possible about the medications that they're taking. We want treatment recommendations to be evidence-based, research informed and prescribed in the safest manner possible."

DR. KROVIAK: "Yeah, I don't have specific comment on the oversight. You're […] meds being manufactured?"

TUBERVILLE: "Foreign manufacturers. Yeah."

DR. KROVIAK: "I mean, I-"

TUBERVILLE: "Which most of them are, by the way. I would think."

DR. KROVIAK: "Right. I mean, this whole medication reconciliation process that I've emphasized in my testimony is really more about the interaction between the prescriber, the provider, and the patient. I think that's where all of this sort of action has to happen to where everybody's on the same page. It's really outside of the VA to where the question you're asking would be put into play. And absolutely, I would not you know, speak against increased scrutiny over the safety of the medications that we're buying and prescribing."

HUNDRUP: "I would just echo that. That's not something that I have familiarity with, but I think that's an important topic that VA should be closely looking at."

TUBERVILLE: "Thank you… Ms. Fletcher, I hosted a field hearing in Montevallo, Alabama, this spring to talk about HBOT and psychedelic-assisted therapy. You think that expanded access to FDA approval of these types of therapies could and would help address the polypharmaceutical issue?"

FLETCHER: "Thank you for that question. I think that access and research into alternative treatments is something that a lot of the warriors that we serve would be interested in. We hear oftentimes that they're coming to us saying that they've tried more traditional therapies and are more eager to pursue the nontraditional therapies when they haven't found that success. But again, we would want these treatment recommendations to again be based on patient safety and evidence informed."

TUBERVILLE: "Thank you. Thank you, Mr. Chairman."

Senator Tommy Tuberville represents Alabama in the United States Senate and is a member of the Senate Armed Services, Agriculture, Veterans' Affairs, HELP and Aging Committees.

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