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SARGEQUANGTRI
06-08-2016, 11:16 PM
Bill Would Let All Veterans Seek Care Outside VA

New push for reform at agency would restructure system of government-run hospital.

All veterans who qualify for Department of Veterans Affairs health benefits would be able to seek care outside the VA under new legislation.
Rep. Cathy McMorris Rodgers (R., Wash.) introduced a draft bill on Tuesday afternoon that would allow any veteran unsatisfied with his or her care at the VA’s network of government-run medical facilities to use their benefits to obtain care in the private sector.
The bill, titled the “Caring for our Heroes in the 21st Century Act,” aims to overhaul the delivery and management of veterans’ health care at a time when the VA is plagued by long wait times, insufficient care, and other failings.
The VA already allows some veterans to seek care at non-VA health providers as a result of legislation enacted after agency staffers were found keeping secret lists to conceal long waits for care in 2014. The controversy led to the establishment of the Choice Program, which allows veterans waiting over 30 days for VA appointments and veterans who live far from VA medical facilities to obtain care outside the VA.
The legislation unveiled by McMorris Rodgers would let any veteran who receives VA benefits and is unsatisfied with his or her care move to the Choice Program.
Veterans would also be able to enroll in the Federal Long Term Care Insurance Program, a benefit that is currently only available to VA employees and other federal officials. They would be able to purchase alternative long-term care insurance in the private market with premium support.
Evidence shows that public opinion is behind an effort to offer veterans more health care options and expand the Choice Program. A Gallup survey released in March found that more than nine in 10 Americans believe that veterans should be allowed to get health care at any provider that accepts Medicare, not solely at VA medical facilities.
McMorris Rodgers’ bill would also restructure the VA’s system of hospitals following an independent assessment released last September that the VA system required “system-wide reworking.”
The bill would reform the Veterans Health Administration by separating its payer and provider functions. It would create the Veterans Accountable Care Organization, a separate government corporation that would be responsible for managing the VA’s medical facilities and delivering care to veterans. Additionally, the legislation would create the Veterans Health Insurance Program to administer veterans’ health insurance programs.
The bill would also set up an independent, nonpartisan 15-member commission of health care experts and veterans to track the law’s implementation and make recommendations to Congress and the VA about veterans’ health reforms. The VetsCare Advisory Commission, modeled after the Medicare Payment Advisory Commission, would be tasked with reviewing the quality of veterans’ care.
For instance, the commission would be able to propose closing certain VA medical facilities that are underused to free up funds for use elsewhere.
Concerned Veterans for America, a veterans group that has advocated for reform at the VA, lauded the bill in a statement Tuesday afternoon.
“The [bill] will reverse the tide of inefficiency and failure at the VA while offering veterans the health care choice they deserve,” said Dan Caldwell, the group’s vice president for political and legislative action, in a statement. “While the usual chorus of special interests and entrenched bureaucrats will fight to protect their political power, Congress must do the right thing by standing with our veterans and implementing this commonsense legislation.”
The latest effort to streamline veterans’ health care comes in the wake of agency data showing rising wait times at VA medical facilities. Over half a million veterans currently have waited more than a month for appointments, according to numbers released last week.
Veterans Affairs Secretary Robert McDonald drew ire from Democrats and Republicans last month for comparing veterans’ waits for appointments to lines at Disney theme parks and arguing that wait times are not a valid metric of success for veterans’ satisfaction.
“When you go to Disney, do they measure the number of hours you wait in line? Or what’s important? What’s important is, what’s your satisfaction with the experience?” McDonald told reporters on May 23. “And what I would like to move to, eventually, is that kind of measure.”
The statements prompted demands for McDonald’s resignation. The secretary later expressed regret for the comments, though he would not explicitly apologize for them.
President Obama has championed McDonald despite controversy, telling the Colorado Springs Gazette in an interview last week that the secretary has “done a terrific job.” Obama appointed McDonald to the top post at the VA after his predecessor Eric Shinseki resigned during the wait list controversy. The president has also claimed that veterans are “extremely satisfied” with VA care once they receive it.
“The notion of dismantling the VA system would be a mistake,” Obama told the Gazette in the interview published Sunday. “If you look at, for example, VA health care, there have been challenges getting people into the system. Once they are in, they are extremely satisfied and the quality of care is very high.”
Auditors with the Government Accountability Office recently concluded that the VA does not perform enough oversight to ensure that veterans receive timely care.

Gates07
06-09-2016, 10:01 PM
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A member of the House Republican leadership on Tuesday released draft legislation to completely overhaul the way veterans receive health care, in part by turning the Veterans Affairs Department’s health care component into a government-chartered nonprofit corporation.

The Caring for our Heroes in the 21st Century Act, introduced by Rep. Cathy McMorris Rodgers, R-Wash., the chairwoman of the House Republican Conference, would create the Veterans Accountable Care Organization to manage the VA’s brick and mortar health care facilities. It also would launch the Veterans Health Insurance Program to manage VHA’s insurance programs, creating two separate entities to handle VA’s payer and provider functions.

The bill, which she introduced as a "discussion draft," would seek to expand choice for veterans by creating a “premium support” model to receive care from non-VA sources. Critics contend that premium support is a voucher system that cuts benefits and leaves veterans on their own to receive care.

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The measure also would create significant changes for the 330,000 employees of the Veterans Health Administration. The new government corporation would have “more latitude to reward high performers, fire poor performers and monitor the quality of overall veteran health care delivery,” an individual briefed on the bill told Government Executive.

Veterans would be able to choose either the VetsCare Federal program -- allowing them to continue receiving care exclusively though the traditional VA system -- or VetsCare Choice -- which would provide them with subsidized private care. Those choosing the latter option could still opt to go to facilities run by the corporation (VACO) to receive care for service-related injuries.

The bill would also open up the Federal Long Term Care Insurance Program, currently only available to federal employees and administered by the Office of Personnel Management, to the entire veteran population.

McMorris Rodgers also wants an independent commission to identify underutilized VA facilities for closure, while giving Congress final veto power. The commission would have to ensure that veterans located in areas with scheduled facility closures would not experience diminished access to care.

The 15-member commission would oversee the implementation of the law generally and continuously monitor veterans health care to make recommendations to Congress and VA for future reforms.

The proposal in many ways mirrors a “strawman report” issued by seven members of the Commission on Care, a panel created by the 2014 Veterans Access, Choice and Accountability Act to suggest a new path forward for VHA. The full commission is holding its final meeting this week before it issues its recommendations at the end of the month.

While the authors of the strawman report say they were simply seeking to align the VA with the needs and desires of veterans, most veterans service organizations -- such as the American Legion and Veterans of Foreign Wars -- oppose the proposals.

Garry Augustine, executive director of the group Disabled Veterans of America, told Government Executive in April that a focus on private care would rob future veterans of the all-inclusive assistance he received upon returning from Vietnam, ranging from vocational training to educational assistance to rehabilitation.

“If I was just given a card and told to go get this taken care of, I would’ve been lost,” Augustine said. He also suggested the proposals would lead to a deficiency of hospitals and clinicians equipped and trained to deal with issues specific to veterans.

“Some of these injuries don’t show up in the private sector that often,” he said. Augustine added that he does not philosophically oppose augmenting integrated care, but cautioned that the providers must become familiar with the intricacies of receiving government reimbursements before accepting veteran patients.

Concerned Veterans for America, a conservative-aligned group controversial for its ties to Republican mega-donors Charles and David Koch, threw its support behind the measure. CVA’s Vice President for Political and Legislative Action Dan Caldwell said the bill would “give every veteran eligible for VA care the ability to choose where he or she receives care.”

“The reality of the VA’s failure is undeniable,” Caldwell said. “The department is not structured to provide timely, sustainable care to veterans, and is in desperate need of ‘system-wide’ reform. The Caring for Our Heroes in the 21st Century Act will reverse the tide of inefficiency and failure at the VA while offering veterans the health care choice they deserve.”

He said he expects dissension from the “usual chorus” of special interests and “entrenched bureaucrats” but called on Congress to “do the right thing” and support the bill.

John Cooper, a CVA spokesman, said the bill would enable veterans to use the same facilities and see the same doctors, “with the only difference being how those clinics and doctors are managed.”

Congress would continue its oversight and funding responsibility for the newly created government corporation.

The reforms are unlikely to receive President Obama’s support or a veto-proof majority, making the chances for passage of McMorris Rodgers’ bill dim. Obama told The Colorado Springs Gazette earlier in June he would not support any move toward VHA privatization.

"The notion of dismantling the VA system would be a mistake," Obama said, touting the progress he said his administration has made in improving the department since the waitlist scandal was unearthed in 2014.

Nevertheless, that the third-ranking House member in the Republican Party would throw her weight behind the transition shows the political winds may be blowing in that direction.

Clarification: Rep. McMorris Rodgers has not formally introduced the legislation in the House. She released a draft. The story has been updated to reflect that.



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