Group says family doctors may opt out of troubled ‘Choice’ program (Stars & Stripes)
Doctors may opt out of a program providing outside health care to veterans caught up in long waits at the VA because the department is not paying high enough reimbursements, a national association of family physicians said this week. Family physicians approached to participate in the multi-billion-dollar Veterans Choice program reported they were offered rates far below the benchmark set by Medicare, the American Academy of Family Physicians wrote Tuesday in a letter to Department of Veterans Affairs Secretary Bob McDonald. The Veterans Choice program began in November but is already drawing criticism from Congress for the very low number of veterans who have made appointments for outside health care. The letter from the AAFP — one of the largest U.S. medical associations — indicates the VA may also have trouble drawing in providers. “Simply put, any public or private payer health plan contract that does not at least meet the Medicare payment rate will remain financially impossible for most medical practices that already operate on extremely thin margins,” Reid Blackwelder, chairman of the AAFP board, wrote to McDonald. The group said doctor reimbursement rates under the federal government’s Medicare health insurance system are used as a benchmark for public and private payers. Some of its nearly 116,000 members are reporting that the VA approached them about being in the Veterans Choice program and offered rates that were 30 percent below Medicare.
VA says it will make announcement next week on Agent Orange exposure of C-123 airmen (WYSO-Public Radio)
The U.S. Department of Veterans Affairs says it will make an announcement next week about treatment for Air Force reservists who may have been exposed to Agent Orange after Vietnam. Ohio U.S. Senator Sherrod Brown has joined the chorus of voices asking for a policy change. As many as 2,100 people who worked on C-123 cargo planes in the Air Force reserves could have been exposed to Agent Orange residues in the 1970s, after those planes had been used in Vietnam to spray the toxic defoliant. The planes weren’t thoroughly cleaned before being reused in the reserves in Ohio, Pennsylvania and Massachusetts. One C-123 that was finally retired to the National Museum of the U.S. Air Force was decontaminated by contractors in the 1990s before going on display inside a hangar. Rickenbacker Air Force Base in Columbus was one of the sites that flew C-123s for medical and other missions, and a growing group of former reservists has been asking the VA for recognition for health conditions that could be related to dioxin, the toxin in Agent Orange. Currently, anyone who was on the ground in Vietnam and has any of a list of diseases associated with dioxin is eligible for what are called presumptive benefits, including disability benefits and money for survivors. But many of the C-123 reservists never went to Vietnam, and almost all have had their claims related to Agent Orange denied by the VA.
Probe finds more scheduling issues at Phoenix VA (AZCentral.com)
An internal Veterans Affairs investigation identified widespread deficiencies within the radiology department at the Phoenix VA hospital, according to a report issued Thursday. The inquiry is the latest in a string of investigations at the Carl T. Hayden VA Medical Center, which was the epicenter of a national scandal that enveloped the federal agency last year. The latest investigation, which was handled by the VA Office of Inspector General, documented issues involving appointment scheduling, staffing and records storage at the 280-bed facility in central Phoenix. The problems affected both inpatient and outpatient services, and cut a wide swath across imaging operations, including X-ray, magnetic resonance image or MRI, ultrasound and mammography services. Investigators documented that:
• Employees used a Microsoft Outlook calendar program for scheduling, a practice that breached VA security requirements.
• Radiology clerks were locked out of the scheduling system, which caused radiology appointments to go missing from patients’ appointment reminder lists.
• Employees stored imaging files improperly, making them difficult to retrieve.
• Administrators mismanaged clerical staffing, leaving gaps in coverage.
Vets not impressed with VA reforms (CNN)
A group of lawmakers and policy activists called for an overhaul of the way the Department of Veterans Affairs delivers healthcare Thursday, arguing the VA should let veterans decide whether to get health care from the private sector. A task force organized by Concerned Veterans for America said the VA should begin offering subsidized private insurance to veterans and transform its healthcare department into a nonprofit corporation instead of a government agency. The move comes in response to the scandal involving healthcare delays and data manipulation at VA facilities first reported by CNN. Sen. Marco Rubio, R-Florida, supported the proposed reforms, saying VA healthcare could improve by adopting the competition and flexibility of private healthcare. “Bureaucrats at the VA are not commanding officers. They should never have the authority to order around our returning heroes,” Rubio said at a policy meeting Thursday. “As soon as the VA is forced to compete with the private sector providers, it will increase the efficiency, the service and its innovation.” Rubio compared the service quality of the VA to the IRS and the Department of Motor Vehicles, saying the time has come to restructure the agency to better meet veterans’ needs. “Paying lip service to veterans is always in vogue, but the true measure of public service … is the willingness to endorse whole reforms,” he said. Rep. Tulsi Gabbard, D-Hawaii, suggested the media attention on the VA scandal generated the political will needed to push short-term changes through Congress last year, but she said problems with health care access and quality persist.
Putting veterans ahead of bureaucracy (AZCentral.com)
Editorial: “To know which way the reform winds are blowing at the Department of Veterans Affairs, one should, as ever, follow the money. Last August, Congress passed an emergency $16.3 billion VA reform package, with $10 billion to be used to provide timely private-sector medical care for veterans. Now, barely seven months later, the VA and White House want a good portion of that money reallocated into the VA system. It should go “to support essential investments in VA system priorities,” President Barack Obama said. In other words, back into an immutable, reform-resistant behemoth. The status quo is a powerful force within this organization. It fights unceasingly against change. And it has allies, including the White House. Well, the forces of change aren’t giving up the fight for quality, veterans-centric health care, either. When Congress passed its funding package last summer, The Arizona Republic recommended a number of dramatic, course-changing reforms for the VA health-care system, which had been leaving sick veterans to wait months for an initial visit with a physician. The recommendations we presented — a drastic reduction in the size and focus of the organization and a renewed emphasis on the VA’s strengths in medical treatment of post-traumatic stress disorder, concussions and physical war wounds — are necessary to refocus the VA from a sprawling federal agency dedicated to serving its own perceived needs to one more responsive to veterans.”
Lawmakers puzzled as to why so few veterans going outside VA for care (Stars & Stripes)
Senators said Thursday a new multi-billion-dollar program to provide outside health care to veterans caught up in long waits at the VA does not appear to be working. Sen. Richard Blumenthal, D-Conn., pressed the Department of Veterans Affairs to figure out why the Veterans Choice program — estimated by Congress to cost $10 billion — has only resulted in 30,000 veteran appointments since the program was launched in November. A second facet of the program that offers vets outside care if they live more than 40 miles from a VA health care facility has been used by just 44 beneficiaries, Department of Veterans Affairs Secretary Bob McDonald told the lawmakers. The participation figures come as Congress is weighing the department’s budget request for the coming year and drilling down on the job performance of McDonald, who was confirmed last summer with the hope he could turn around the VA and root out poor management. “The choice card program basically seems to be not working,” Blumenthal said. McDonald told the senators that about 500,000 VA beneficiaries have called about the program but those calls resulted in just 30,000 appointments or clearances, meaning the vets’ request was resolved. “That seems like an awfully low ratio to us,” he said. The VA has produced a YouTube video to advertise the program and is looking at its marketing approach for possible tweaks, McDonald said. “Even though we have been at this for a while, the last [Veteran Choice] cards went out in January, and right now it is the end of February, so it is early days,” McDonald said.
VA chief backs outside care as ‘Choice’ program falters (Associated Press)
Veterans Affairs Secretary Robert McDonald said Thursday he remains committed to a law making it easier for veterans to get private health care, but he offered few answers for lawmakers irritated at the slow effort to put the law in place. “I’m as frustrated as you all are,” McDonald told the Senate Veterans Affairs Committee, as he explained low enrollment numbers for the VA’s new “choice” program. Far fewer veterans than expected are taking advantage of the program, which is intended help veterans avoid long waits that have plagued VA facilities nationwide. Only 27,000 veterans have made appointments for private medical care since the VA started mailing out “Choice Cards” in November, the VA says. The number is so small, compared to the 8.6 million cards that have been mailed out, that McDonald wants authority to redirect some of the $10 billion Congress allocated for the program to boost care for veterans at the VA’s 970 hospitals and clinics. Republicans and Democrats alike told McDonald that was a non-starter. Several senators questioned VA’s commitment to the choice program, the centerpiece of an agency overhaul by approved by Congress last year in response to a scandal over long wait times for veterans seeking health care and falsified records covering up the delays. The law allows veterans who have waited more than 30 days for an appointment to get VA-paid care from a local doctor. It also allows veterans who live at least 40 miles from a VA hospital or clinic to get private care and makes it easier to fire VA employees accused of wrongdoing.
Lax VA payments to Louisiana providers leave veterans saddled with debt (Baton Rouge Advocate)
Louisiana veterans are running up debt because a federal agency isn’t paying their medical bills on time, according to the chief of the state’s veterans agency. Federal law authorizes the U.S. Department of Veterans Affairs to provide health coverage for eligible military veterans when they are “financially liable” for emergency medical services provided at a local non-VA hospital or ambulance company. But the VA division Congress recently put in charge of getting the bills paid isn’t doing its job, said David LaCerte, secretary of the state Department of Veterans Affairs. “Unfortunately, VA employees have ignored the intent of Congress and refused to pay these bills on time, leaving hundreds of Louisiana veterans with medical debt they should not have incurred,” LaCerte wrote members of Louisiana’s congressional delegation. The delays reportedly have lead to “negative impacts” to the credit of 229 Louisiana veterans, he said. In addition, LaCerte said Thursday that inadequate VA outreach has left many Louisiana veterans unaware of potential financial risks. “The VA outreach to people and explanations needs to be better,” LaCerte said. In July, the VA owed Louisiana medical providers more than $35 million. By February, the debt rose to an estimated $48 million, according to the Louisiana Hospital Association. “Louisiana’s veterans sacrificed to preserve our freedom, and they deserve to have their medical bills paid on time,” LHA President Paul Salles said. “Congress needs to put an end to the VA backlog and require the VA to improve outreach to our veterans with unpaid bills.”
Uber partner has been illegally repossessing active duty, veterans’ cars (The Verge)
Auto lender Santander Consumer USA has agreed to pay at least $9.35 million to resolve the accusation that it illegally repossessed over 1,100 vehicles from active military personnel. The company is a close partner of the ride-sharing giant Uber, which funnels drivers with low credit to Santander loan officers. It’s not the company’s first brush with the law: the lender holds over $40 billion in car loans and has repeatedly been the subject of criminal investigations into its subprime auto loan arm. According to the US Department of Justice, Santander violated the Servicemembers Civil Relief Act (SCRA), a consumer protection statute that forces lenders to seek court approval before repossessing assets of active duty soldiers. Since the Civil War, military personnel have been afforded some degree of special protections from civil claims like bankruptcy, foreclosure, and divorce. In 1919, the SCRA was enacted to allow military personnel reprieve from debt collectors while fighting in World War I. Today, companies like Santander are still required to verify the military status of loan holders against a federal database. If a soldier makes a payment on a loan but then becomes delinquent, the courts often intervene and delay repossession. The SCRA is intended to ensure that soldiers do not return from active duty and find their homes foreclosed or their cars repossessed.
Women veterans younger, more depressed when referred for cardiac testing (UofMHealth.org)
Women veterans getting medical attention for chest pain were younger and more likely to be obese, depressed and suffer from post-traumatic stress disorder than men veterans, according to a study published in an American Heart Association journal. The number of women cared for by veteran affairs facilities has doubled in the past decade, providing a unique opportunity to examine the heart health of women veterans. The study reveals women veteran face a home front battle against heart disease that’s significantly different from men veterans and women who have never served in the military. Although chest pain was a common reason for women to undergo cardiac catheterization, a medical procedure to diagnose and treat some heart conditions, doctors were less likely to find blockages in women’s arteries that could lead to a heart attack or stroke, says lead study author Melinda B. Davis, M.D., cardiologist at the University of Michigan Frankel Cardiovascular Center and the VA Ann Arbor Healthcare System. The findings may prompt a closer look at stress-induced heart disease, and coronary microvascular disease — spasms in the walls of very small arterial blood vessels which can lead to severe and long-lasting angina, or chest pain – as causes of chest pain for women veterans.
New York City to track veterans receiving benefits (The Wall Street Journal)
New York City would be required to track the number of veterans applying for and receiving city benefits, under legislation passed Thursday by the City Council. Though the city’s estimated 200,000 veterans are eligible to receive certain housing and employment benefits, lawmakers said they don’t know how many are applying for and receiving them. The bill, sponsored by Councilman Paul Vallone, would force certain city agencies to report the number of veterans and their surviving spouses who are seeking and receiving help. Most veterans benefits are managed by the federal government but some city agencies, such as the New York City Housing Authority, oversee programs that administer benefits to veterans. NYCHA, for example, administers the federal Veterans Affairs Supportive Housing program, which provides rental assistance for homeless veterans. Vallone, a Queens Democrat, said the legislation would increase accountability of city agencies to veterans. A second bill passed Thursday would impose a number of transparency measures on the Veterans Advisory Board, a group of nine appointed by the mayor and the City Council.
Palin demands Obama put veterans ahead of ‘illegal aliens’ (Breitbart News)
On Thursday, former Alaska Governor Sarah Palin ripped the Obama administration for putting the needs of illegal immigrants ahead of veterans who sacrificed to ensure the nation’s freedoms. At the Conservative Political Action Conference (CPAC), Palin referred to the Veterans Administration’s wait-list scandal and said, “we can’t wait for D.C. to fix their bureaucratic blunders.” Palin demanded that veterans get vouchers to get treatment outside of the VA. “Give our vets the same freedoms they gave us,” she declared. “And instead of illegal aliens cutting in line and being rewarded with a handout of U.S. benefits, we demand that the vets are first in line.” She blasted the “corrupt government” for putting veterans on secret waiting lists, deceiving Congress, and then spying on investigators who were trying to get to the bottom of the scandal. “The bureaucracy is killing our vets,” Palin said, noting that the VA’s blunders have killed at least 500 veterans. She also ripped the the media that “doesn’t cover lame-duck scandals anymore” for not digging more into the Veterans Administration wait-list scandal after VA Secretary Eric Shinseki resigned. “The reason why you don’t hear about them is because our vets don’t whine,” she said. “They’re not wired to complain. That’s why this ran under the radar for so long.”
Veterans and their families warned about pension fraud (WPMT-Harrisburg)
Attorney General Kathleen G. Kane and Acting Adjutant General James R. Joseph today warned Pennsylvania veterans and their families to be aware of schemes aimed at selling veterans financial products they don’t need or charging them for services which are otherwise free. These kinds of schemes, referred to as “pension poaching,” may be perpetrated by attorneys, financial planners, insurance agents or others who use misleading or incomplete information to encourage veterans to make decisions about their finances in order to qualify for benefits. Kane said her agency’s Office of Military and Veterans Affairs has received reports of dishonest planners or people misrepresenting themselves as veteran service officers targeting veterans in senior centers, assisted living facilities and other locations where they couple guarantees about qualifying for benefits with a high pressure sales pitch for their products. “Some unscrupulous financial planners attempt to take advantage of our veterans by offering high-priced services that veterans and their families can typically obtain for free,” Kane said. “Veterans should avoid these dishonest advisors and keep the money that’s rightfully theirs. My Office of Military and Veterans Affairs is committed to advocating on behalf of veterans and protecting them from scams.” Often, pension poachers try to convince veterans to transfer their assets or invest in insurance products to qualify for Aid and Attendance benefits, but don’t disclose how those transactions impact the veteran’s eligibility for other federal programs like Medicaid.
Delegation urging VA secretary to save Hot Springs VA (Associated Press)
The South Dakota congressional delegation is continuing to urge Veterans Affairs Secretary Robert McDonald to withdraw plans to reconfigure the VA Black Hills Health Care System from President Barack Obama’s budget proposal. Sens. John Thune and Mike Rounds and Rep. Kristi Noem met with McDonald on Wednesday to reiterate their concerns. The VA has served veterans in Hot Springs for more than a century but now wants to move some services to Rapid City. The Hot Springs VA hospital is listed on the National Register of Historic Places but could be shuttered. The delegation says McDonald assured them that no final decision has been made yet about the future of the Hot Springs VA. Thune says the White House should stop giving veterans the “bureaucratic run-around” and start providing answers.