Waiting Too Long at VA? New Law May or May Not Help.

 Words by Bridget Foster/ 8/23/2014

President Obama signed the new Veterans Affairs Department reform bill into law August 7th, but it will be a while before veterans see any of its effects. The VA has 90 days to draft and submit interim rules for implementing the law. Viewed by some as a stop-gap measure to address the wait-times fiasco that exploded into the news earlier this year, among other things, the bill contains provisions to “allow” veterans to seek health care outside the VA system (which the current system already provided for under certain circumstances).

The catch is there are so many restrictions written into the bill that one has to wonder just how many vets will benefit from the “changes” and whether it goes far enough to address the broken VA system.

Through the Veteran’s Access, Choice and Accountability Act, veterans have to meet strict criteria to benefit from the Veterans Choice Card, which is supposed to facilitate private sector care.

For starters, veterans must have been enrolled in the VA health care system prior to August 1, 2014 and those enrolling after that date must have been on active duty in a combat zone during the previous 5 years. Correct me if I’m wrong, but that sounds like anyone coming out of the service after August 1st that did not serve in Iraq or Afghanistan, won’t be able to take advantage of the “Choice Card.”

VA data from the beginning of August shows almost 30,000 new patients still faced wait times of 90 days or more to see a physician. What we don’t know is how many of those 30,000 will be eligible for expedited care under this new bill. And even once the veteran qualifies to seek care from the private sector, Section 101 (h) of the bill specifies that the coverage is only good through the first 60 days. So if the veteran’s condition requires continued care beyond those 60 days…guess what? Back to the VA waiting room he or she goes.

Ok, so let’s say the veteran gets past the hurdle of being eligible to receive the Choice Card and now wants to select a private sector provider…now comes the next hurdle.  The veteran has to find a provider that is willing to accept the rates paid by the VA, which cannot exceed established Medicare payments unless the provider is in what the VA considers a “very rural area.” 

Let’s talk about a possible third hurdle…that Choice Card? It basically just identifies who the veteran is and requires the provider to contact the VA to verify that outside treatment has been authorized. How much longer will THAT process add to the wait time for care? Your guess is as good as mine.

One last thing; we know that the VA is already challenged administratively to provide the services promised to our men and women who proudly served this country.  Coordinating the expansion of private sector care, monitoring the quality of that care and making sure those private sector records get integrated into the VA’s system adds a huge burden on an already taxed system.