What’s in the $15 Billion Legislation from Congress for Veterans?

By now most veterans and their families have seen the headlines on the VA health care scandal, secret waitlists, and the like. In light of this scandal, Congress has been working with uncharacteristic haste to provide a solution and help veterans get proper care.

The key points in the new package include a $15 billion budget boost to the VA, a “Veterans Choice Card,” and, potentially, leases on 27 new medical centers in fifteen states and Puerto Rico (another $1.27 billion).

The centerpiece of the “Veterans Access, Choice and Accountability Act” (HR 3230) is a $10 billion Veterans Choice Fund. Over the next three years, VA is to use the fund to buy care from non-VA care providers for veterans if they face long waits longer than 30 days for VA care or if they reside more than 40 miles from a VA medical center.

The goal: to eliminate the egregiously long VA patient wait list, which some VA health administrators and staffed conspired to hide in recent years.

Per the request of some VA leaders and veteran service organizations, HR 3230 also authorizes $5 billion for VA to expand its own capacity to deliver care, by hiring more medical and support staff and also building and leasing more space. This $5 billion will be paid for by cuts elsewhere, including cuts to executive bonuses and deferring planned rate cute for certain VA home loans.

However, the “Veterans Choice Card,” which the legislation mandates, is not the golden ticket that it sounds like for veterans seeking outside care. Veterans not already enrolled in VA health care won’t gain accelerated access to outside care as promised by the legislation, unless they serve in areas of combat operations within five years of enrollment.

The choice card will mostly act as an informational insurance card presented to non-VA health care providers to identify the veteran and to verify eligibility for care that, sometime earlier, were arranged through and approved by a VA coordinator.

Also, not all eligible veterans will get to choose their outside provider, and not every outside provider will opt to treat veterans through the VA coordinated care program – even if the vets are existing patients. The issues for outside physicians include the level and timeliness of VA payments. The new legislation does include language seeking to improve VA payment procedures so that payments are timelier.

VA has existing contracts with individual physicians and with pools of private sector providers, and additional similar arrangements are expected. But, VA cannot pay rates higher than Medicare allows, with exceptions possible if care is delivered in rural areas.

Many question marks remain with this legislation and how it might be implemented. It certainly does not represent a cure-all for the VA’s problems, however it does include some near-term action. You can read more on this story in Stars & Stripes: http://www.stripes.com/news/veterans/how-choice-card-and-15b-will-help-veterans-get-care-1.296110