Don’t Allow VA to Sabotage Real Reform
9:12 AM, Jun 24, 2014 • By PETE HEGSETH
Forty-four years after the legendary May 1970 Life magazine cover story first exposed the disgusting and shameful mistreatment of our nation’s Vietnam-era veterans in government medical facilities, the U.S. Department of Veterans Affairs (VA) is once again in desperate need of reform. Courageous whistleblowers have exposed systemic corruption and exposed falsified records, secret waiting lists, and delayed care — representing yet another scandalous and unconscionable neglect of our nation’s veterans.
Over the years and decades since the reforms of the 1970s, the VA’s calcified bureaucratic culture has undermined and eroded all accountability within the department. But despite the scandals throughout VA finally gaining mainstream media attention and appropriate outrage, the VA and its allies on Capitol Hill are working behind the scenes to sabotage much-needed accountability and patient choice reforms proposed by Congress.
Following passage in the House of Representatives of two Rep. Jeff Miller-backed bills to bring greater accountability and real choice to the VA, the Senate has passed its own solid, yet flawed, package.
With the competing House and Senate proposals now headed to a conference committee to be reconciled this week, it’s time to get tough. Members of Congress, veterans’ advocates, and taxpayers must remain vigilant to ensure real reform language is shielded from sabotage by bureaucratic apologists who seek to preserve VA’s dysfunctional status quo.
To avoid diluting the reform provisions, and allowing the VA to once again betray its sacred calling, conference committee members should be wary of the following three vulnerabilities to real reform:
Close loopholes and remove ambiguous language. The VA has proven in the past that, if given discretion to interpret statutory language, they’ll do so in a way that protects and rewards its bureaucracy to the detriment of veteran care. Congress should dictate strict, unambiguous, and automatically triggered guidelines to deny the department this leeway. Patient choice provisions, which would allow VA beneficiaries to seek care from private providers when facing long waits, or if they live far from a VA facility, are particularly vulnerable to sabotage.
The first example is the health care wait time standard for seeking private care. The final conference bill should reflect a clear and carefully delineated standard — say, 21 days — to define what constitutes “excessive” wait times for care. The VA should never again be permitted to set their own standard for “excessive” waits, nor should veterans require high-level approvals to seek reimbursed private care. Also, veteran wait times must be independently verified as the VA has proven time and again that it will falsify records to hide the truth. If the wait standard is not met, automatic triggers must be in place for the veteran to quickly seek other providers.
Another good example of where language must be clearly defined is the geographic standard for seeking private care. Both bills establish 40 miles as the standard for excessive travel to a VA facility; meaning a veteran can seek private healthcare options if they live further than 40 miles from a VA facility. But this begs the question: what constitutes a “VA facility” — primary hospitals or every clinic? And will individual radiuses be set according to individual veterans? If a veteran lives within 10 miles of a VA clinic, but has to receive specialized care 100 miles away, Congress must ensure that that the veteran still qualifies for other options.
Ensure timely reimbursement payments to VA providers. Private medical providers who have treated VA patients in the past tell of disproportionately long reimbursement delays — in many instances taking several months, or even years, for the VA to settle accounts. By comparison, Medicare providers are typically reimbursed within 30 days.
Delaying payments is a passive-aggressive bureaucratic strategy to undermine patient choice: if doctors know they’ll have to wait months for VA payment, they’ll be less willing to accept its patients, thereby gutting the choice provisions. Congress should mandate timely reimbursements for private providers similar to Medicare’s pace, thereby ensuring broad choice for veterans.
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