New proposal would expand VA Choice program

New legislation would expand VA Choice
Sen. Lindsey Graham (Corey Schmidt | WBTV)
Sen. Lindsey Graham (Corey Schmidt | WBTV)
(Source: WBTV/File)
(Source: WBTV/File)

WASHINGTON, D.C. (WBTV) - A new proposal before the United States Senate could put increased pressure on a federal program for veterans that many say already doesn't work.

A group of senators—led by John McCain (R-AZ) and including Lindsey Graham (R-SC) and Thom Tillis (R-NC)—proposed The Care Veterans Deserve Act in late April.

The bill would allow any veteran currently qualified to receive medical treatment through the Department of Veterans Affairs to get a Veterans Choice Card that would allow access to the private medical providers of their choice.

DOCUMENT: Read The Care Veterans Deserve Act

Currently, certain veterans qualify to receive VA-funded care from private medical providers through the Choice Program if they would have to wait more than 30 days to see a VA specialist or if they live more than 40 miles from the nearest VA medical facility.

The Choice Program was created in the fall 2014 to address a massive backlog of patients waiting to see specialists at many VA medical facilities.

"I get complaints and praise about the VA all the time. You had people die waiting to be treated by the VA, so what's the solution?" Graham said in an interview with On Your Side Investigates from his office on Capitol Hill. "This idea of veterans' choice outside of the VA system's time has come."

But a months-long investigation into the VA Choice Program shows the current system, open to just a fraction of veterans, is not providing expedited care as intended.

In February, we spoke with two veterans who had experienced long waits or delayed treatment because of problems with Choice.

In March, we spoke with medical providers who had decided to stop accepting new Choice patients because the program's administrator, Health Net, was not paying for treatment and it was nearly impossible to get treatments authorized.

"Most doctors' offices in the area have stopped taking Choice patients," On Your Side Investigates asked Graham.

"The whole point of this bill is to correct that problem," he said. "The VA is trying to stop what I think is a long overdue reform.

INVESTIGATION: Slow VA Choice authorization, reimbursements frustrate doctors' offices

Internal VA records obtained from the Salisbury VA Medical Center in show it can take months for Choice patients to even be scheduled for an appointment.

A list of cases awaiting an appointment through Choice obtained by On Your Side Investigates in March showed 51 veterans waiting for a Choice appointment through the Salisbury VAMC.

Of those 51 veterans waiting, some had been waiting since December and early January for specialty care including cardiology rehab and pain management.

Administrators at the VA acknowledge problems with the Choice Program but say they're working to fix them.

"Does the VA Choice Program work?" On Your Side Investigates asked Kristin Cunningham, Director of Business Policy for the VA.

"You know, the VA Choice program started in August of 2014 with the enactment of the law, we had about 90 days to get it up and running and we wanted to make sure that we met that deadline so we worked very quickly to get it up and running and it was a slow start," Cunningham said. "There's a lot of challenges with it, and we realize that, and we've really been working to make improvements to it."

Cunningham said one of the things the VA had already addressed was changing the reimbursement policy so that medical providers could get paid in a timely fashion.

Previously, Cunningham explained, the VA would have to have proof of treatment before it authorized payment. Now, the VA has changed its rule to allow Health Net to pay the provider once a bill is submitted.

When we raised other questions about who at the VA is keeping Health Net accountable, Cunningham said she was unable to answer that.

"I think we have to find the right solution and I'm not sure what the right mix is but we definitely want to make sure we get the right care for our veterans," Cunningham said.

Senator Lindsey Graham acknowledged that the recent legislation to expand the Choice Program is just one in a flood of recent proposal introduced in Congress aimed at streamlining the VA.

"There's a fight and war going on up here about how to serve veterans better when it comes to health care," Graham said.

But, ultimately, Graham said President Barack Obama is responsible for ensuring the VA provides veterans with the care they deserve.

"It's going to change but it's going to take the president," Graham said. "John McCain and Lindsey Graham are going to do our part to make sure the VA better serves the veteran and shake up the status quo but it's going to take the president and somebody hands on in the White House to make this work."

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