Congress and the Department of Veterans Affairs (VA) agree that the troubled Veterans Choice health benefit needs an overhaul. The program, currently managed by TriWest and Health Net Federal Services contracted by the VA, is considered largely broken.
The key to needed reform, according to VA Secretary Robert McDonald, is the contractual relationship with private care providers to develop a network of options for veterans, instead of third party administrators managing the scheduling and billing processes.
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Congress created the $10 billion Veterans Choice program in 2014 to allow veterans to see private healthcare providers if they were not able to get an appointment at a VA facility (hospital or clinic) within 30 days, or they lived a prohibitive distance away. It has become obvious to all involved that a formal system of care coordination is needed.
Towards the end of 2015, the VA asked Congress for legislative changes. Lawmakers have been working with the VA since that time to draft legislation and with the White House to fast track the bill through the legislative process.
Recently, Senate Democrats, led by Jon Tester of Montana, a ranking member of the Senate Subcommittee, introduced a bill, S 2633, to consolidate a number of VA community care health programs under one Veterans Choice umbrella. It details how the VA secretary would work with private providers to give veterans better access to health care. The Veterans Choice Improvement Act, S 2646, sponsored by Senator Richard Burr and fellow Republicans, includes stringent requirements of reimbursement rates and mandate that the VA provide compensation to veterans within 90 days of determining a former service member’s presumptive condition. Supporters speak of its flexibility to provide quality, institutional care within the VA for veterans who want to access it and make the Veterans Choice Act work.
The goals of legislation include:
- Making it easier for veterans to understand their health care options and receive treatment
- Putting accountability at the VA
- Providing care to those injured before September 11, 2001, offering the same benefits as received by those after that date.
The actions represent a fundamental shift in veterans’ health care, changing how veterans find outside health care.