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With the Stroke of the Presidential Pen, VA Choice Program is Replaced

With the Stroke of the Presidential Pen, VA Choice Program is Replaced

With the Stroke of the Presidential Pen, VA Choice Program is Replaced

 

By Debbie Gregory

On June 6th, President Donald Trump signed the VA Mission Act, replacing the Veterans Choice Program.

The Mission Act consolidates seven programs. It expands private health care options, expands caregivers assistance to the families of disabled veterans, and orders the Department of Veterans Affairs to inventory its 1,100+ facilities with a long-term view to downsize.

“This is a very big day,” said Trump, who made veterans care one of the signature issues of his run for the White House. “All during the campaign, I’d say, ‘Why can’t they just go out and see a doctor instead of standing on line?'”

American Legion spokesman Joe Plenzler said, “The American Legion worked very hard on this legislation with the administration and with Congress.” He added, “We were very pleased that the president signed it, and we look forward to implementing every piece of this legislation as discussed and negotiated.”

“We’re allowing our veterans to get access to the best medical care available, whether it’s at the VA or at a private provider,” said the president.

The bill will address the restrictions in the current caregiver program that provides stipends to family members who care for severely disabled veterans. The current program has been limited to post-9/11 veterans, but the bill was aimed at expanding caregivers assistance to veterans of all eras, possibly adding more than 41,000 caregivers.

The price tag for the VA Mission Act has been estimated to be between $52 billion and $55 billion. Members of Congress still haven’t fully figured out how they’ll pay for the Mission Act.

Direct patient care, suicide prevention, medical research, job training and many more vital veterans programs could face cuts in funding in order to pay for care in the community under this new plan.

Allegations of Skimming Impacts VA’s Private Healthcare Providers

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By Debbie Gregory.

TriWest Healthcare Alliance and Health Net Federal Services, the companies charged with administering private health care options for veterans, are both under investigation for over-billing the government by tens of millions of dollars.

The Veterans Access, Choice and Accountability Act, expected to cost taxpayers $10 billion has come in closer to $12 billion to date, and that between the two companies, they have collected at least $89 million more than what they were supposed to.

The VA Choice program was launched during a very rough time for the VA Health System, when allegations of misuse, misconduct, claim backlogs and long wait times for veterans seeking treatment at its facilities were every day occurrences. It was created as an emergency stopgap to serve patients who were waiting weeks or months to see doctors in a backlogged VA healthcare system.

To alleviate part of the problem,  if the VA is unable to schedule an appointment for a veteran within a month, or if a veteran lives more than 40 miles from one of its clinics, they can access a network of private clinicians and hospitals managed by TriWest and Health Net.

An audit revealed that both companies billed the VA for more than what they paid medical providers, charged different rates other than what was contractually set up, submitted duplicate bills for the same services, and billed for medical services already covered by private health insurance.

TriWest maintains they have done no wrong, blaming the VA’s billing system for the overpayments. But this isn’t the first time TriWest has been investigated for mismanaging government funds. In 2011, the company paid the Justice Department $10 million to settle a lawsuit that the company systematically defrauded the government.

Inspector General Michael Missal estimated that, in duplicate payments alone, Health Net and TriWest overbilled taxpayers by $89.7 million.

Health Net was instructed to reimburse $50.8 million; TriWest allegedly owed $38.9 million.

Both TriWest and Health Net’s current contracts will run for the next 10 months.

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