Giving Veterans Options for Health Care

By Paul Pender MD

Published on Linked-In June 8, 2018

The President recently signed into law measures to extend the Veterans Choice program for health care, the VA Mission Act. The bill received bipartisan support but questions remain over funding. Supporters of the law claim that safeguards are built into the legislation so that veterans will be able to seek and receive care in the private sector. Critics warn that a change in interpretation of the language in the law may negatively impact choices for veterans.

The big question is whether the US Department of Veterans Affairs learned from its past mistakes. The original version, Veterans Choice, was cobbled together in 90 days in response to the disgraceful treatment of veterans and the fraudulent entries for waiting times for appointments by VA employees. The public outcry from learning that VA supervisors were awarded bonuses despite substandard care of veterans forced Congress to launch a program to give veterans access to health care outside of the VA system. I am among those physicians who agreed to treat veterans under the terms of the Veterans Choice program. Many of my peers refused to participate in the program because of delays in reimbursement and hassles in obtaining authorization for treatment. They concluded it just wasn’t worth chasing the federal government for payment when so many hurdles had to be jumped.

I personally spoke up for veterans, and for those of us who provided care for them, at a town hall meeting in 2016 attended by our US Senators, the Chief of the Medical Staff at our local VA hospital, representatives from the insurance intermediary for Veterans Choice and veterans groups. It was clear from that meeting that veterans faced too much red tape to embrace a program that would give them access to care in the private sector.

Our service men and women deserve better. A vet with bilateral cataracts might have to wait months with poor vision before getting authorization for cataract surgery under Veterans Choice while my private patients could be booked in a matter of a few weeks. Some payments for either the facility or for the surgeon’s fee under Veteran’s Choice were delayed a year, while my Medicare fees for the same procedure were paid within 3 weeks. While promises were made at the town hall meeting to streamline the approval process, veterans continued to face delays. Unlike billing and payment done electronically for Medicare and other insurance programs, paper claims were required under the Veterans Choice program. Paper claim submission only added to delays and mistakes in entering and processing claims. No wonder so few of my physician colleagues participated in the program. Veterans should not have to fight for their health care; they already fought for our country.

The passage of the law recently signed by the President offers an opportunity to make good on the promise of better care, delivered promptly. It is the least we can do for our veterans and those who serve them.