Veterans outside providers waiting months to get paid?

Pappas talks with VA community about veterans healthcare

Union Leader
By Bea Lewis
Jan 23, 2020

LACONIA — First District Congressman Chris Pappas met with VA community care providers on Thursday and heard about the hurdles veterans and their care providers face, in their efforts to give and receive effective medical treatment.

Louie Fladger, left, of Northwood, was among a group of veterans who met with Congressman Chris Pappas, center, about the benefits of acupuncture when Pappas held a listening session at Gate of Life Acupuncture and Wellness Center in Laconia on Thursday to learn more about the difficulty VA community care providers are having in obtaining reimbursement from the VA. Bea Lewis/Union Leader Correspondent

When veterans need health care that the VA cannot provide, they can obtain services through community care providers. Gate of Life Acupuncture and Wellness in Laconia contacted Pappas’ office because they said they were not receiving payments from the VA in a timely manner for treating veterans for a variety of health issues.

Kathy Twombly, the acupuncture practitioner and massage therapist who runs the Main Street business, said the stalled payments were not only creating a financial hardship, but that billing system obstacles were interrupting the care veterans needed.

“It took three months to get the first payment and represents thousands of dollars,” Twombly said.

Once veterans get a referral for acupuncture, they are allowed 12 visits within 45 days, then eight visits within 83 days and then eight more over 173 days.
read it here

Veterans Choice left them over billed by at least $53.3 million at emergency rooms

Thousands of Vets May Have Wrongly Been Billed for Emergency Care

Military.com
By Richard Sisk
8 Aug 2019

At the start of fiscal 2016, claims backlogged more than 30 days totaled 482,000, or 28% of the total of 1.7 million claims, the report said. However, the backlogged claims had increased to 36% of all claims by November 2018, the report said.

Hospital emergency room sign. Getty Images

Veterans may have wrongly been billed by the Department of Veterans Affairs for emergency room medical treatment at non-VA facilities totaling at least $53.3 million, according to the office of the VA Inspector General.

Following an audit, the IG estimated that "about 17,400 veterans, with bills totaling at least $53.3 million, were negatively affected" by either initial denial or ultimate rejection of their claims for reimbursement.

The IG also estimated that that "if corrective actions are not taken, these errors could result in $533 million in improper underpayments to claimants over five years."

The IG's 70-page report, titled "Non-VA Emergency Care Claims Inappropriately Denied and Rejected," said the reimbursement issue rested with the VA's Claims Adjudication and Reimbursement Directorate (CAR) in the VA's Office of Community Care.
read it here

USA Today has some explaining to do!

USA Today has some explaining to do!

"Veterans sacrificed enough: USA TODAY investigations of VA health care help our heroes"

That was their headline, but if they are referring to reports like this, they need to explain what the rest of the story was and why they did not report it!

"In Phoenix, reporter Dennis Wagner's coverage of the VA crisis led to nationwide investigations and major changes in veterans' health care, as well as in the administration's accountability and transparency. Internal VA investigations verified that patients were dying while awaiting care and documented widespread mismanagement and reprisals against whistleblowers."

"The VA secretary was forced out. Congress approved a $15 billion emergency fund and launched the Veterans Choice program giving VA patients a private-care option."

Reporters keep doing that! Patting themselves on the back for only telling part of a story the rest of us live with...and if you read Wounded Times, read all the time too.

Here are some other headlines on this topic.

Veterans call program to get health care with civilian doctors 'a disaster,' broken

Veterans from around the state expressed frustration over the Veterans Choice program, meant to increase access to health care, during a listening session in Helena on Monday night.

Independent Record reported that on 10/24/2017 and veterans added that the VA had gone downhill over the last 8 years.

The Cherokee Tribune had a report in May of 2018 that 1.3 million veterans had been overcharged and were getting reimbursements.

And in June WHIO 7 News reported this mess.

A key program being expanded by the Trump administration to give veterans greater access to private doctors has failed to provide care within 30 days as promised due to faulty data and poor record-keeping that could take years to remedy, according to a government investigation released Monday. The Government Accountability Office, Congress’ auditing arm, found veterans often had to wait between 51 and 64 days for appointments with private doctors under the Veterans Choice program. It cited a lengthy scheduling process that took as long as 70 days.

Read more of this type of pat on the back while the rest of us are scratching our heads instead of pulling our hair out!

"New VA leadership carried out what has been described as the most comprehensive overhaul in agency history."

Treating veterans like the rest of us in never right. Sending veterans into the same system members of Congress have been complaining about, is even worse. When reporters get a pat of the back for not telling the whole story, that is the worst!
Military.com had this in June.

The GAO said veterans could wait up to 70 days for private-care appointments under the Choice program because of poor communication between the VA and its facilities and "an insufficient number, mix, or geographic distribution of community providers."

As for the Whistleblowers protection, you can look that up yourself since that has also been going on for a very long time. Yep~Congress yet again. 

 

Members of Congress Should Be Ashamed

UPDATE: POTUS does not understand what he just signed!

"What a beautiful word that is — choice — and freedom to our amazing veterans," Trump said at the signing ceremony. "All during the campaign I'd go out and say, 'why can't they just go see a doctor instead of standing in line for weeks and weeks and weeks?' Now they can go see a doctor."

REMINDER: THEY SHOULD NOT BE TREATED LIKE EVERYONE ELSE, AND OH, BY THE WAY...THEY ARE WAITING IN LINE BECAUSE OF CONGRESS!!!!

If the person you elected had voted against Affordable Care Act Vote list then turned around to support sending veterans into the same situation, they need to be publicly humiliated! 

Why? Because apparently they thought this healthcare coverage was so bad for us THEY DECIDED TO PUT VETERANS INTO THE SAME MESS and this is the result!

The Government Accountability Office, Congress’ auditing arm, found veterans often had to wait between 51 and 64 days for appointments with private doctors under the Veterans Choice program. It cited a lengthy scheduling process that took as long as 70 days.

When they decided to treat disabled veterans just like everyone else, they hoped we'd be too stupid to notice what billions paid to private companies could have do to fix the VA for all veterans.

Then again, we were too stupid to notice that Congress has had jurisdiction over how we show veterans what we think of them GOING BACK TO 1946~

If this is not enough for you to actually hold them accountable, watch this video from a couple of years ago. Veterans should never have to take this betrayal! They did their jobs! Make members of Congress do their jobs!


And yes, they are helping each other out of the dumpster!

1.3 million wrongly charged veterans eligible for refunds

VA payments to wrongly charged veterans begin; Up to 1.3 million veterans eligible
Cherokee Tribune and Ledger News
Thomas Hartwell
May 1, 2018

According to Jim Lindenmayer, director of the Cherokee County Homeless Veterans Program and American Legion 9th District service officer, at least 750,000 veterans who received emergency care from non-VA medical centers and were billed through Medicare Part A or other insurance programs are eligible for reimbursement. He said there may be up to 1.3 million veterans affected by the Staab case going back several years.

BALL GROUND – After a three-judge panel on the U.S. Court of Appeals for Veterans Claims ruled unanimously last year that the Department of Veterans Affairs wrongly charged VA-enrolled veterans millions in emergency medical bills, the government entity has begun to pay partial claims. Local veteran advocates say there are many Cherokee veterans who could be eligible for reimbursement.

The VA lost its fight in the Staab vs. Shulkin case (originally filed as Staab vs. McDonald) in April 2016. Air Force veteran Richard Staab served from 1952-1956 and was forced to use non-VA emergency care in 2010 when he had a heart attack and underwent open heart surgery. Medicare covered a portion of his $48,000 bill, but the VA medical center in St. Cloud, Minnesota denied his request for the reimbursement of the remainder. Staab filed a notice of disagreement in May 2012.

Until January the appeals court decision benefitted only Staab, but the VA has since revised a rule that allows payment of hundreds of thousands of claims like Staab’s.
read more here

So, how is that "Veterans Choice" thing working out?

Remember how many times Congress said they needed more money to cover veterans being sent away from the VA? 

Any idea where that money went if they didn't pay the bills?

Department of Veteran's Affairs years behind on payments to local hospitals
WAVI 5 News
By Emily Tadlock
Mar 26, 2018

AUGUSTA, Maine (WABI) Many hospitals in Maine provide services to veterans through the VA Choice Program, a system where veterans can choose to receive care closer to home instead of traveling to a VA facility far away.

But, the Department of Veterans Affairs is slow at paying the bills for those services.

Congressman Bruce Poliquin spear-headed a discussion in Augusta Monday designed to ensure hospitals are paid what they're owed.

Lisa Harvey-McPherson with Eastern Maine Healthcare System says, "It's a system wide issue from the Aroostook Medical Center to our hospitals in Hancock County to our very rural hospitals in Pittsfield and Greenville. The Veterans Administration is fundamentally challenged to pay their bills on time. It's highly inefficient on their end and on our end to spend so much time reviewing each and every claim in an effort to get paid."

The Department of Veterans Affairs is years behind on their payments and millions of dollars in debt to hospitals for veteran's services.

This is a challenge for all hospitals, especially for those in rural parts of our state.
read more here

Considering those yahoos thought that veterans becoming disabled serving this country were no longer due the best care we could give them!

Yes, they forget to mention that part all the time. 

This is what "Choice" did to veterans...choosing dying over debt?

7 Investigates: Veteran: Even after law change, veterans fearing medical debt choosing dying over ER
care
WSAW 7 News
By Matthew Simon
Feb 15, 2018

"Why would it be so hard to take healthcare reform, strike out the notion veterans don't deserve the same rights as every other American?” Zehrung asked. “You don't have to give me a handout. You don't have to revise the entire Veterans Administration. All you have to do is allow me to buy health insurance and I will pay for it myself."

PITTSVILLE, Wis. (WSAW) – A disabled Pittsville Gulf War veteran says the risk of medical bill debt is still too great to go to his closest ER during an emergency. That’s despite the Veteran Administration recently changing how the agency will pay some non-VA emergency bills.

"This can't take forever and a day,” Jerry Zehrung said. “Because every day this legislation is delayed is another day another veteran has to ask themselves should I go to the ER or should I wait. And some of these decisions, you're not going to convince me, aren't costing veterans their lives."

In January, the VA published their updated non-VA emergency payment rule, known as the Staab rule. It’s named after 85-year-old Minnesota Air Force veteran Richard Stabb, whose $48,000 emergency claim was denied by the VA because Medicare had paid a portion of his bill.

A House Veterans Affairs Committee spokesperson says the Jan. 9, 2018 change only applies to veterans who have extra insurance, and at the same time, are only seeking care for an emergency not associated with a military service injury, like Staab.

The rule change means nothing has changed for veterans like Zehrung, who only have VA provided insurance, or those who think they need emergency help because of an injury received while serving.

“When you have something like this case that comes up, and you have a lot of veterans that get together, and they commingle and they talk, and their spouses talk, and word gets out there's a chilling effect. I’m going to avoid any hospitalization or care unless I'm absolutely on my death bed because I don't want to be saddled with the extra cost of care," Jacqueline Schuh, the lawyer behind the lawsuit that led to the Staab rule’s implementation, said.
read more here

Veterans "Choice" is for promises to be kept!

When officials talk about "Choice" they omit the fact that our veterans should never be subjected to having to chose between the healthcare they were promised, or having to deal with the system the rest of us have to endure. After all, these are the same folks who continually remind us how bad our system is. These men and women became disabled serving this country, but apparently the long list of presidents forgot that part!

If it does not work right, they forgot it was their job to fix it! The picture above has President Lincoln because of the motto the VA uses. The other presidents, starting with Kennedy, are all the presidents we've had since I was born. None of them have lived up to the promise to "care" even though all of them talked about how much they did.

This is why I do not like politicians on either side!

There is an article about Choice Act that offers a great reminder of a very simply fact,

The Choice Act reimburses veterans who seek medical care outside of VA. There are two bills pending in Congress to amend it. Trump favors the one that would most aggressively expand options for veterans to see providers who are not on the government payroll, saying the beleaguered agency can’t adequately care for the 9 million veterans it serves.

It isn't as if the over 20 million veterans are all going to the VA. It is less than half and only 20% go to the VA for all their healthcare. So when do Presidents and Congress actually live up to that motto?

Veterans Call "Choice" a Disaster

HINT TO CONGRESS: VETERANS WANT THE VA TO WORK AND YOU GUYS TO ACTUALLY DO YOUR JOB AND MAKE SURE IT DOES! STOP SELLING THEM OUT AND PUTTING THEM INTO THE MESS THE REST OF US HAVE TO DEAL WITH!!!!

Veterans call program to get health care with civilian doctors 'a disaster,' broken

Independent Record

Holly K. Michels

October 24, 2107

Veterans from around the state expressed frustration over the Veterans Choice program, meant to increase access to health care, during a listening session in Helena on Monday night.

Veteran Don Paul discusses the tribulations he endured while trying to acquire new prescription glasses during a town hall meeting at The American Legion Post in Helena.Thom Bridge, thom.bridge@helenair.com

Nearly 50 veterans came to American Legion Post No. 2 to talk about their experiences with Veterans Affairs Department health care. The town hall is one of about a dozen the Legion will hold around the country this year to gather feedback to share with state congressional delegations and VA officials.

“That Choice is broke, broke, broke,” said veteran Tom Johnson, who said he was employed by the VA for more than three decades. “The VA has gone downhill drastically in the last eight years.”

read more here

Lawmakers Only Want to See Choice They Want Veterans To Take

No real need to wonder if these politicians noticed it is their job to make sure the VA takes care of our veterans. After all, they had the authority since 1946, ergo, if the VA has problems, it was their job to fix them.

So why didn't they? Why would they want to spend this kind of money on private healthcare providers instead of actually fixing the problems with the VA? Easy answer is, private healthcare providers will make a lot more money off "treating" our veterans. 

Veterans not only deserve the best care this nation can give, but should never have to settle for the least lawmakers are willing to do! None of these problems veterans face are new ones.

Lawmakers to take on veterans issues after weeklong recess
STARS AND STRIPES
By NIKKI WENTLING
Published: July 8, 2017

Shulkin is seeking emergency funding or authority from Congress to transfer money from a community care account that holds about $2 billion. Currently, he does not have the power to move money between the accounts.

Vice President Mike Pence speaks at the White House Eisenhower Executive Office Building in Washington on May 8, 2017, as veterans from Colorado were in town participating in an Honor Flight event. A host of veterans issues are slated to be addressed as lawmakers return to Washington following the July 4th holiday break.
WHITE HOUSE PHOTO

WASHINGTON — As they return this week from a July Fourth break, lawmakers are set to discuss Department of Veterans Affairs health care, its 2018 budget, how veterans are affected by the opioid crisis and how the VA handles claims for Gulf War Illness – all while facing a short timeframe to do something about quickly diminishing funds in the VA Choice program.

Choice funding VA Secretary David Shulkin warned lawmakers June 16 that money was unexpectedly running out for the Choice program, which allows veterans to seek health care outside the VA. Despite projecting the VA would roll over $626 million for Choice funding into the next fiscal year, Shulkin said the fund would be depleted by Aug. 7.

He attributed the faster spending to the increased popularity of the program among veterans this year.

Now, there’s concern that without action from Congress, more veterans will have to receive care within the VA, creating longer wait times and adding stress to the system that the Choice program was meant to alleviate.

VA budget
A Senate Appropriations subcommittee will propose a fiscal 2018 VA budget at a Wednesday meeting, which will be followed by a full committee markup of the proposal Thursday morning.

Last month, House appropriators proposed a $182 billion budget for the VA, an increase from 2017 levels but still short of the $186.5 billion Trump is calling for.
read more here

Congress Didn't Plan Veterans Choice Program

Program to hasten veterans’ care poorly implemented, Maine advocates say
Portland Press Herald
BY STEVE MISTLER STAFF WRITER
January 30, 2016

Health Net Inc. is one of the program managers cited in the report. It’s also the company charged with managing the Veterans Choice program in Maine and New England.

A report released Thursday shows that a 2014 program designed to reduce wait times has left half the qualifying veterans without medical appointments.

AUGUSTA — Advocates for Maine veterans said Friday that the rush to implement a $10 billion federal program designed to shorten wait times for veterans seeking medical care is contributing to delayed care, unbooked doctor appointments and billing errors.

“It was doomed for failure before it even hit the streets,” said Gary Laweryson, a retired Marine from Waldoboro who is chairman of the Maine Veterans Coordinating Committee.

There have been a number of reports in Maine and other states that the 2014 Veterans Choice health program is not working as intended. Those complaints, once anecdotal, were validated Thursday in a report produced by the VA Maine Healthcare System showing that only half of the 4,300 veterans who applied for care under the 2014 Veterans Choice program had received appointments since July.

The report was presented to veterans advocates and staff for the state’s congressional delegation during an unannounced meeting held at the VA’s Togus campus. The meeting has prompted urgent calls from Maine’s delegation to reform the program.

However, veterans advocates say the program was hastily conceived and carelessly implemented. Those assertions are supported by a U.S. Veterans Health Administration Office of Inspector General report issued in September.

Amedeo Lauria, a service officer for the American Legion at Togus, said veterans are having a difficult time just getting a call returned from a hotline provided by the choice program. On Thursday, Health Net said a call center in Tampa, Florida, was set up for 500 employees. Only 130 have been hired.
read more here