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Congress acts to address VA issues

June 13, 2014

The House and Senate moved quickly this week to pass similar pieces of legislation allowing veterans to seek care from private providers if they face long wait times at Veterans Affairs (VA) facilities.

The legislation responds to growing concerns about long wait times experienced by veterans seeking health care through the VA.

The Senate June 11 voted 93-3 to pass legislation, the Veterans Access to Care Through Choice, Accountability and Transparency Act, H.R. 3230 – the Senate incorporated its legislation into the bill passed by the House a day earlier – that would allow veterans to go to civilian doctors for the next two years if they live more than 40 miles from a VA treatment center or if they have exceeded the current wait-time – typically 14 days – for an appointment. It also provides funding for more health providers in the VA system.

The legislation also includes plans for 26 new medical facility leases for the VA, at an estimated cost of about $1.4 billion, and provides $500 million for hiring new VA doctors and nurses. Both moves are expected to improve access for veterans, and hopefully cut down on wait times.

The bill also would ensure that wait-time statistics are no longer used in performance evaluations of VA officials, after investigators found that some of the record-keeping problems stemmed from administrators trying to protect their annual bonuses.

The House June 10 voted 426-0 to approve the Veterans Access to Care Act. Like the Senate measure, it would require the VA to offer nonVA care at the department’s expense to any enrolled veteran who cannot get an appointment within VA wait-time goals or who lives more than 40 miles from a VA medical facility.

Any care provided by a nondepartment facility not under an existing VA contract would be reimbursed at the rate set by the VA, Tricare or Medicare, whichever is greatest. The Senate bill provides for care provided by a non-VA facility to be reimbursed no higher than Medicare’s rate. Congress needs to reconcile the differences between the bills.

AHA President and CEO Rich Umbdenstock hailed Congress’s prompt action, and said the legislation “will help expand veterans’ access by allowing them to more easily secure private providers.” He urged Congress to “move expeditiously” to resolve differences between the bills. The AHA “looks forward to working with our [VA] colleagues, Congress and the administration to ensure veterans receive the care they need when they need it,” he added.


The quick passage of the legislation was a strong response to the outcry over backlogs and falsified data at the beleaguered agency, which serves nearly 9 million veterans. The controversy led Eric Shinseki to resign as head of the VA on May 30.

On June 9, a VA audit of scheduling and access management practices at 731 VA facilities showed more than 57,000 new applicants for care have had to wait at least three months for initial appointments. In addition, 63,869 veterans who enrolled in the VA health system over the past 10 years have not been scheduled for an appointment, the department said.

The audit found that a complicated scheduling process resulted in confusion among scheduling clerks and frontline supervisors in a number of locations, and that a 14-day wait-time performance target for new appointments was inconsistently deployed and not attainable given growing demand for services and lack of planning for resource requirements.

Among other actions, Acting VA Secretary Sloan Gibson said the agency is eliminating the 14-day scheduling goal from employee performance contracts, and will post twicemonthly updates to the access data and apply immediate access reforms to the most challenged VA facilities.

The department also released quality and efficiency data from a scorecard model being developed for internal benchmarking, known as SAIL, and data from its national mental health provider survey at www.hospitalcompare.va.gov.