Government and Regulations

Senate, VA Agree—Veterans Choice Act Needs Fixing

“We need your help,” Secretary Robert McDonald Tells Senate.


Numerous reports have surfaced of veterans “experiencing adverse credit reporting or debt collection” and health care providers refusing to care for veterans because of slow payments and other accounting issues. Other concerns with VCA have ranged from lack of access to urgent and emergent care to the confusing array of separate programs created by VCA. In response, the VA has created a Community Care Call Center, and the U.S. Senate is considering 2 bills to fix issues with the Veterans Choice Act (VCA).

“VA has consistently failed to reimburse the hospitals for services rendered,” explains Senator Richard Burr (R-NC). Burr helped draft the original Veterans Choice Act (VCA) and the Veterans Choice Improvement Act, which aims to correct issues with the VCA. According to Burr, the bill would establish a standard for how long it takes the VA to reimburse claims and ensure that late payments accrue interest.

The Improving Veterans Access to Care in Community Act also tackles other complaints about the original bill—the confusing array of separate programs it established for seeking non-VA care. “The laws and regulations that govern these programs differ in substantial ways, and this is confusing to the veteran, confusing to doctors and hospitals, and oftentimes, confusing to the VA itself,” Senator Burr explained.

Under the new legislation, the VCA programs would be consolidated into a single permanent program, the Veterans Choice Program. Previously, the VCA was established as a temporary program.

Although VA officials professed happiness with making VCA permanent, Sharon Johnson, MSN, RN-BC, president of the Nurses Organization of Veterans Affairs (NOVA) expressed concern in a statement submitted to the committee. “NOVA believes that making Choice permanent at this time would be a mistake and that further review and oversight of the many issues occurring in the field is needed. We also believe that the veteran should be at the forefront as you consider all forms of non-VA/fee-based care.”

Veterans service organizations largely liked what they saw in the legislation. “Both bills address deficiencies in current law, as well as provide a comprehensive framework and foundation for consolidating the purchase of care in the community,” Louis J. Celli, Jr. of the American Legion told the Senate panel.

Carlos Fuentes of the Veterans of Foreign Wars concurred, noting that the legislation would “improve how veterans access community care options and ensure the private sector supplements, not supplants, the excellent health care veterans receive from VA health care professionals.”

The 2 bills offered differing approaches to whether the VA could create tiered networks of non-VA providers. Disabled American Veterans (DAV) and the VA urged the committee to adopt the tiered model, which could produce what the DAV described as “Veterans-Centered Integrated Health Care Networks” of VA and non-VA providers, whereas the American Medical Association strongly opposed the concept.

During the hearing, Secretary McDonald also answered questions related to the hiring and firing of VA employees, which now seems to be under control. The new legislation offers a number of fixes to make it easier for the VA to remove employees, although the rules may not directly impact health care providers. “All the individuals in the medical professionals in the VA should be Title 38,” McDonald explained to the committee. “Title 38 gives us the ability to hire directly, which will speed up the hiring process and make us competitive with the private sector. Title 38 will allow the VA to pay more competitively and recruit more competitively.”

A final signed bill is expected by the end of May 2016.

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