The Trump administration is seeking to extend an Obama-era initiative that allows military veterans to seek care from private doctors if Veterans Affairs facilities have excessive wait times.
During a congressional hearing on Wednesday, VA Secretary Dr. David Shulkin asked members of the House Veterans' Affairs Committee to continue the Veterans Choice program beyond its current Aug. 7 expiration date. Prior to Veterans Choice's launch, the VA had come under fire for ballooning wait times that had contributed to neglectful care and even patient deaths.
“If we don't do this extension, this is going to be a disaster for veterans,” Shulkin said at the hearing. “We're going to see the same problems as 2014.”
The program has been a financial boon for non-VA providers. The $10 billion, three-year program was created by Congress to improve access and reduce wait times for veterans who typically seek care from VA facilities.
Shulkin asked lawmakers to extend the program until appropriated funds run out. Without that extension, VA facilities cannot schedule appointments with Veterans Choice providers beyond Aug. 7. The department estimates the program will have approximately $950 million left in its coffers at that point.
Shulkin provided no explanation for why the program has excess funds, but Veterans Choice has been beset with administrative woes that may have slowed down spending, according to reports from the VA inspector general and Government Accountability Office.
Under Veterans Choice, veterans who have waited at least 30 days for an appointment at a VA facility or have to travel more than 40 miles for VA care can receive federally funded treatment from local, non-VA doctors. Over 1 million veterans have received care under the initiative, according to VA data.
The extension will also give the agency more time to develop a modified choice program that will be easier for veterans and providers to use, Shulkin said. He provided few details about the revised program, other than hinting that it would streamline the claims payment process and eliminate the time and distance restrictions in order to expand veteran access.
Non-VA providers have criticized the choice program for paying claims and turning over medical records too slowly.
“One doctor said 'it's easier to get gold out of Fort Knox than it is to get medical records from VA,' ” Carlos Fuentes, deputy director of Veterans of Foreign Wars, the largest veterans advocacy group, said in a statement to the House committee.
The American Medical Association has also recommended revamping the VA reimbursement process to alleviate physician and provider concerns with the Veterans Choice Program.
Shulkin acknowledged that the program has had problems, many of which stem from the short notice Congress gave the VA when it established Veterans Choice. The Veterans Access, Choice, and Accountability Act of 2014, which established the VA Choice Program, gave the department only 90 days to implement the initiative.
“This was unprecedented and created many growing pains,” Shulkin said at the hearing.
The House Veterans Affairs Committee on Wednesday advanced a bill to eliminate Veterans Choice's sunset date and allow the program to continue to access its funding. Sens. John McCain (R-Ariz.) and Jon Tester (D-Mont.) introduced the Senate version of the bill this week.
“We cannot afford to let the Veterans Choice program expire and send our veterans back to the pre-scandal days of unending wait-times for appointments,” McCain said in a statement on Tuesday.