Letter to The Honorable Robert McDonald, Secretary of Veterans Affairs - Crapo Calls on VA to Improve New Veterans Choice Program

Letter

The Honorable Robert McDonald

Secretary

U.S. Department of Veterans Affairs

810 Vermont Avenue, NW

Washington, D.C. 20420

Dear Secretary McDonald:

The 2014 revelations about wait time manipulations within the health care system of the U.S. Department of Veterans Affairs (VA) was the catalyst for significant changes at the VA and Congressional oversight. To understand better the impact on veterans, I reached out to Idahoans to ask for their input on how they would like the VA to function. Two state-wide surveys of the veterans' community and more than 150 town meetings across Idaho have revealed important unmet needs and concerns of Idaho's veterans.

For many veterans, the Veterans Choice Program (VCP) is not working as it should, and many Idahoans would like to see the department reinvigorate other non-VA care programs providing individual treatment outside the VA system. Some recommend that the VA directly hire more health care providers to address unmet care delivery needs. I understand the VA cannot adequately fill vacant positions because of nationwide provider shortages. This challenge clearly requires a robust complementary outside care program to exist in tandem with the Veterans Health Administration network.

The Surface Transportation and Veterans Health Care Choice Improvement Act requires the VA to "develop a plan to consolidate all non-Department provider programs by establishing a new, single program." As you develop a plan to consolidate the non-VA care programs, please pay special attention to the needs and experiences of Idaho's veterans.

As this work continues, please provide me with an overview of your work. Additionally, I would like to know the following:

What steps will the VA take to address the special needs of rural and highly rural communities?

How will veterans' individual insurance plans be affected by the non-VA care program consolidation?

How will the consolidated non-VA program interface with TRICARE?

How will the VA ensure timely and accurate reimbursement of providers?

How will the VA ensure third-party administrators (TPAs) are reimbursing providers in a timely and accurate manner?

What role will TPAs serve in a consolidated program?

Many Idahoans have expressed concerns after having difficulty reaching the TPAs. How will the VA ensure its TPAs are providing timely assistance to veterans?

Will the VA ensure that veterans have another means to schedule care if the TPA is untimely?

What training will VA staff and TPAs have to understand and administer the new consolidated program?

As Congress and the VA work to improve the VCP and veterans' access to care, these issues must be properly addressed to ensure future program revisions work for Idaho's veterans. The state-wide surveys show VCP failures can be attributed to the following problems:

1) Many veterans have a hard time working with the TPAs. Complaints include that the TPAs take too long to schedule appointments, frequently outside the veterans' preferred 30-day window. Other veterans have shared stories of poorly-trained staff and long telephone wait times.

2) Idahoans indicate the VCP reimbursement rate is lower than the negotiated rate for several of the other non-VA care programs. This has the effect of discouraging provider participation. Veterans once able to use an alternative non-VA care program through certain providers must now travel long distances because the same providers will not participate in the VCP. Further, the VA has directed VISNs to use the VCP before using any of the other non-VA care programs. This direction further compounds the problem.

Please consider these problems as the Department moves forward in the non-VA care program consolidation process.

In order to fully understand the needs of Idaho's veterans and servicemembers, I invite you to visit our great state. Please suggest a few dates that work for your schedule. Your presence in Idaho will mean a great deal to the veterans and servicemembers I represent.

Thank you in advance for your response and for your efforts to address the needs of Idaho's veterans.

Sincerely,

Source