Three members of President Donal Trump's informal group at Mar-a-Lago club in Palm Beach, Fla., made numerous recommendations from 2016-18 on various Department of Veterans Affairs initiatives, including its $16 billion EHR contact with Cerner, according to a recent Government Accountability Office report.
The group of men comprised Marvel Entertainment Chairman Ike Perlmutter, West Palm Beach, Fla.-based physician Bruce Moskowitz, MD, and lawyer Marc Sherman. In 2018, ProPublica published a report that claimed the "Mar-a-Lago crowd" was able to view the VA's EHR modernization contract with Cerner. The trio has little to no health IT or federal contracting experience, according to the report.
In its recent report, the GAO analyzed 223 email exchanges between the three men, referred to as "private citizens" and VA. Of the email exchanges, 77 mentioned the Cerner project or interoperability in some capacity. The timeline focused on 2016-18 and the report was conducted between April 2019 to May 2020.
"[Review of the] email exchanges indicates that the three private citizens acted as organizers by scheduling meetings with VA officials and helping to plan events, such as the VA’s medical device registry summit that occurred in June 2018," the report states. "At times, the emails show they acted as advisors by making recommendations regarding, for example, the Cerner contract negotiation, mobile application development, and potential candidates for senior level VA positions."
The GAO report claims that input from the three private citizens may have contributed to the "strategic pause" that VA took on the EHR contract with Cerner in late 2017 to focus on interoperability; however, a former VA official told the office that the delays were also to ensure the contract was comprehensive. VA signed in 2018 the 10-year contract for $10 billion, which was later increased to $16 billion to cover additional program management and infrastructure costs.
The three men said they did not play a formal role in the agency and had no decision-making authority, according to a written statement from the individuals. However, former VA officials disagreed and said the trio held "some degree of power and influence," according to the report.
"A former VA official told us that the three private citizens created a 'shadow reporting structure' in which they were stakeholders without a formal role," the report states. "As a result, according to the official, the period in which he was at the VA when the three private citizens were advising VA created confusion for some VA staff who recognized the power and influence of the three private citizens but were not given clear guidance on how to handle that power or make decisions under that influence."
A current VA official told GAO that there "was no impact" because the advice from the three private citizens did not require VA to stray from its strategic plans or decisions on key projects.
Click here to view the full report.