New Proposed Legislation on Veterans' Access to Healthcare Outside the VA

BY TOM BURKE

Media sources have reported that there is a move in Congress to allow veterans to get health care outside of the Department of Veteran Affairs without VA prior approval. A new bill called The Veterans Health Care Freedom Act would supposedly make it easier for veterans to obtain medical services from doctors in private practice by removing eligibility requirements for non-VA care. The bill, introduced by Rep. Andy Biggs (R-Ariz.) in December, has collected several co-sponsors.

Sen. Marsha Blackburn (R-Tenn.) introduced a companion bill in the Senate that would enable veterans to make appointments with a clinician in private practice without the VA first determining the medical service is not readily available at a VA health facility close to where they live.

Legislation of a similar nature was introduced several years ago but gained no traction. However, the number of lawmakers interested in easing the rules about community care apparently have grown, along with demands among veterans to change the rules for community care.

Records indicate that around 40 percent of care is now provided outside the VA. The Senate bill is designed to give veterans more control over how and where they receive their healthcare. The bill is co-sponsored by Sens. Tommy Tuberville (R-Ala.), and Roger Wicker (R-Miss.).

Passage of the Mission Act in 2018 enabled veterans to receive health care coverage outside the VA for service-connected disabilities. The VA now covers the cost of care delivered by private doctors registered with the agency’s healthcare network. However, the veteran must meet certain conditions to receive care from a physician in private practice.

The VA now pre-approves the service before appointments are made. Veterans are told that they must prove that they face long delays for treatment or in getting specialty medical treatment in the VA. Usually, availability of service is the bigger question within a reasonable time period. With the shortage of personnel that the VA is experiencing and long waits for service, this is not something the VA wants to address.

As I understand it, the plan is to have this legislation authorize a three-year pilot program allowing veterans to go to outside doctors without first receiving a referral from the VA. The program would be funded through the VA’s current budget.

Supporters indicate this legislation would give veterans access to making appointments with primary and specialty-care doctors and mental health counselors in their community when seeking urgent care.

Current complaints range from delays, follow-up when tracking appointments, verifying authorizations for appointments, and delays delivering reimbursement after medical treatment. There is a belief that the VA discourages veterans from seeking community care with a mountain of red tape and lack of availability of local providers. Legislators believe veterans should have access to community healthcare facilities to provide more choices for medical care to avoid long waiting times.

I have received information concerning freestanding kiosks that veterans can use to submit travel expenses for medical care at VA clinics and hospitals. They have been reintroduced a year after the VA closed them down. This VA system had become a nightmare that no veteran wanted anything to do with.

Several hundred kiosks in VA facilities are being reactivated with more to come later. The VA will again accept the mail-in paper form for remittance of travel costs. Veterans have reported the reimbursement process is difficult to navigate.

Many believe that the VA made everything a burdensome process so they could avoid spending more money for care.

Veterans are reimbursed for their travel expenses to doctor’s appointments for treatment of service-connected injuries or illnesses. Veterans traveling for a compensation or pension exam also can submit their travel expenses. Veterans who have fixed incomes sometimes travel long distances for their care. They rely on timely delivery of their travel reimbursements to help with expenses.

The VA spent $36 million dollars on a web-based system in 2023 supposedly to speed up reimbursements to veterans. The portal for reimbursements had a complicated, confusing log-in system process. Navigation of the system discouraged its use.

According to the VA, the claims reimbursement program paid out $1.3 billion in 2022 to cover fuel costs and tolls that veterans incurred to get to their medical appointments. The Inspector General review of the VA system faulted the VA for not soliciting veteran feedback before the system was introduced and said that veterans were not given needed training in using the new system to enter travel claims.

Remember you must make sure that you are entitled to reimbursement before you can apply for the benefit. Your VA facility should be able to advise you if you qualify or not.

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