VA eases method for paying Choice doctors; senators remain skeptical

by Patricia Kime

Veterans Affairs officials announced changes this week to the reimbursement requirements for the Veterans Choice program, modifications they say will help speed payments to physicians, but they also urged Congress to support legislation that would let VA have greater flexibility to fix the troubled health program.

VA said Tuesday it has dropped a requirement that physicians participating in the Veterans Choice program submit a copy of a veteran’s medical record in order to receive reimbursement from VA.

According to VA, doctors still will be required to furnish the medical information to ensure that the VA knows what services were provided, but submission will no longer be tied to payment.

“This administrative step just makes sense,” VA Undersecretary for Health Dr. David Shulkin said of eliminating the medical records requirement for payment. “It ensures veteran access, timely payments and strengthens our partnerships with our Choice providers.”

Long delays in reimbursements have discouraged many physicians from participating in the Veterans Choice program, which allows veterans to seek care from a private doctor if they can’t get an appointment at a VA facility within 30 days or live more than 40 miles from a VA hospital or clinic.

In some cases, the payment delays have destroyed veterans’ credit, because physicians have sought payment directly from their patients or forwarded bills to collection agencies.

During a hearing on the VA budget on Thursday, Senate appropriators reproached the VA for the botched rollout of Veterans Choice, which has been beset by access problems and delays in payments and care.

Sen. Lisa Murkowski, R-Alaska, said Veterans Choice destroyed a carefully built system of community care for Alaska veterans and she implored Shulkin to fix it.

“[The term you used to describe Veterans Choice], ‘somewhat problematic,’ is not what I’m hearing from veterans,” Murkowski said. “They are saying it is fouled up, it is screwed up. It is unacceptable. … We had corrected it and you came in and created chaos.”

“The intent of the Choice act was to give veterans more opportunities to seek timely care in their communities, but as we all know, in practice, it simply is not happening,” said Sen. Jon Tester, D-Mont., who placed the blame on the VA, the original legislation and Health Net Federal Services, the contractor overseeing VA Choice appointments and the provider network in his state.

“Health Net is inept, and until they step up and do the job they were hired to do, and paid to do, I’m going remain being very, very critical of the work they do,” Tester said.

The VA has made several changes to the program, to include hiring more claims processing staff and establishing new productivity standards.

It also asked Congress for legislation to allow VA to streamline several community care programs into a single entity that will have better defined eligibility rules and smoother access to appointments and medical care – legislation introduced Thursday by Tester and co-sponsored by four other Democratic senators.

The legislation, S 2633, would consolidate seven VA community care programs and include physician and contractor participation requirements.

Tester said he would work with the Senate Veterans’ Affairs Committee to get the legislation, which has the VA’s support, passed.

Shulkin said the legislation is needed to fix a program that has good intentions for veterans.

“The Choice program is not working the way anyone wanted. … We are going to stick at this until we can get this working better for veterans,” Shulkin said.