Trump administration seeks to overhaul Veterans Choice program

The Veterans Affairs Department is seeking Congress' help to overhaul an Obama-era initiative that allows military veterans to seek care from private doctors if VA facilities have excessive wait times.

During a Senate hearing on Wednesday, VA Secretary Dr. David Shulkin outlined his vision of a revamped Veterans Choice program, which would be renamed the Veterans Affairs Community Care Program and aim to further empower doctors and patients.

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. More than 1 million veterans have received care under the initiative, according to VA data.

The new program would jettison the day and mile requirements. Instead, a VA clinician would perform a health risk assessment on a veteran and determine if the VA or a private provider would be the best place for the patient to receive care and work together on the next steps for treatment.

"This will give veterans real choice in getting the care they need and ensure it is of the highest quality," Shulkin told members of the Senate Committee on Veterans Affairs. "At a minimum, where the VA does not offer a service, veterans will have the choice to receive care in their communities."

The revamped program approach would ensure that service-related ailments that are better treated by the VA will continue to be treated there, while more universal maladies are treated in a patient's community.

The VA Choice Program is set to sunset later this year and Shulkin is hopeful that legislation to launch the Care program will be passed by the end of September, the end of the fiscal year.

Advocacy groups such as Disabled American Veterans said they supported the new vision. Adrian Atizado, deputy national legislative director for the group, told lawmakers at the hearing he believed the changes would make accessing appropriate care, both in and outside the VA, easier than it is now under the Choice program.

Shulkin and lawmakers agreed the VA Choice program needed to be improved. Sen. Jon Tester (D-Mt.), ranking member on the committee, said the program has actually made access worse for veterans in his state.

"I've been looking forward to this hearing because Choice has been such a train wreck," Tester said. "It was supposed to increase availability of healthcare and it's done just the opposite."

Veterans in his state and elsewhere have said it has been hard to get a timely appointments and providers say it takes too long to get paid under the program.

In April, President Donald Trump signed legislation meant to address the provider payment issue. The VA had been relying on a third-party vendor to oversee payments. Starting this summer, the VA will pay claims directly.

Other members of the committee wanted assurances that the VA would continue to make progress improving its own care capabilities and that the Trump administration wasn't attempting to totally privatize care for veterans. The VA system has at least 45,000 provider vacancies across the country.

"If you only give your customers a choice to get out, you're going to rob the resources from a system that we need to make sure is working," Sen. Patty Murray (D-Wash.) said.

Shulkin said he agreed and insisted that work is continuing to also ensure access to care in the VA system.