House to ex­am­ine bill that would speed pay­ment from VA Choice pro­gram

Modern Healthcare - - THE WEEK AHEAD - —Vir­gil Dick­son

The House Vet­er­ans’ Af­fairs Com­mit­tee wants to make per­ma­nent a pro­gram that al­lows for­mer ser­vice­men to re­ceive care from pri­vate providers and speed up pay­ments to par­tic­i­pat­ing hos­pi­tals.

The VA Choice pro­gram has been marred by ad­min­is­tra­tive and fi­nanc­ing woes since it was en­acted via leg­is­la­tion in 2014. The pro­gram was cre­ated in re­sponse to a scan­dal where some vet­er­ans died while wait­ing months for ap­point­ments at VA fa­cil­i­ties.

Congress and Pres­i­dent Don­ald Trump had to in­ter­vene ear­lier this year to save the pro­gram as it was on the verge of run­ning out of money. De­spite an emer­gency in­fu­sion of $2.1 bil­lion, the pro­gram is still ex­pected to be tapped out by De­cem­ber.

To turn things around, the House Vet­er­ans’ Af­fairs Com­mit­tee plans to dis­cuss leg­is­la­tion Tues­day that will make the pro­gram per­ma­nent, draw­ing on fund­ing from the Vet­er­ans Health Ad­min­is­tra­tion. The bill also seeks to sim­plify the pro­gram.

If the new law is passed, the VA Choice pro­gram will no longer rely on a third­party ad­min­is­tra­tor to con­tract and pay providers. Hos­pi­tals have com­plained that the ar­range­ment led to slow pay­ments that were be­low Medi­care rates.

The pend­ing leg­is­la­tion calls on the VA to pay claims no later than 45 days af­ter re­ceiv­ing them and ruling on ap­peals for de­nied claims no later than 30 days af­ter be­ing re­ceived.

It also ends re­quire­ments that vet­er­ans can only go to a pri­vate provider if they have to wait 30 days or more for a VA ap­point­ment or drive more than 40 miles to a VA fa­cil­ity. Un­der the pro­posed bill, if the VA is un­able to quickly get vet­er­ans into care, they would be as­signed to a pri­vate provider.

“The pur­pose of the leg­is­la­tion is to stream­line and re­form VA’s com­mu­nity care pro­grams,” said Tif­fany Haverly, a spokes­woman for Rep. Phil Roe (R-Tenn.), chair­man of the House Vet­er­ans’ Af­fairs Com­mit­tee.


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