VA secretary urges extension of troubled Choice program

Shulkin, who previously served as VA’s top health official in the Obama administration, says Congress must hurry to extend the Choice plan beyond its Aug. 7 expiration date, or the VA will lose nearly $1 billion left over in that account. That money can provide stopgap care until a broader revamp is designed, he said.

“There is no time to waste,” Shulkin told the House Veterans Affairs Committee. “Many veterans are using the Choice program today, and it is important to continue to care for and support those veterans.”

On Tuesday, Sen. Jon Tester, D-Mont., introduced legislation with Sens. John McCain, R-Ariz., and Johnny Isakson, R-Ga., that would extend the Choice plan until its money runs out, likely in early 2018. The bill also calls for fixes in the program to speed up VA payments and promote sharing of medical records.

“Have no doubt: If we let this program lapse, more than a million veterans will lose their ability to visit a community provider, the VA system will once again become overwhelmed, and veterans will go back to the pre-scandal days of unending wait-times for much-needed care,” McCain told the House committee, noting that the VA has said a broader revamp could take two years.

That panel led by Rep. Phil Roe, R-Tenn., was scheduled to consider a House version of the bill Wednesday.

Major veterans’ organizations and Democrats are closely watching the VA’s planned overhaul of the Choice program, after President Donald Trump’s transition team signalled in late December it was weighing a “public-private” option. Under that plan, veterans could get all their medical care in the private sector, with the government paying the bill. Veterans groups generally oppose that as a threat to the viability of VA medical centres.

After Trump selected him to be VA secretary, Shulkin has said he would not privatize the VA. He expressed support for an “integrated model,” without sketching the full details.

He says he wants to eliminate restrictions in which veterans may seek outside care only in cases where they had to wait more than 30 days for an appointment or drive more than 40 miles to a facility. But Shulkin also says he wants the VA to handle the scheduling and “customer service” for those outside appointments, something that the Government Accountability Office, Congress’ auditing arm, indicated could be problematic.

GAO recently reassigned a “high-risk” rating to VA’s health programs, citing in particular problems with its choice program. Randall Williamson, GAO’s health care director, said veterans could wait up to 81 days to receive outside care due to bureaucratic problems, in contrast to a stated goal of 30 days or less.

Williamson said the VA also faced significant challenges in overhauling the Choice program, citing the department’s outdated information technology systems as well as likely additional costs and staffing needed to administer the changes.

On Tuesday, Shulkin said he hopes to propose a broader overhaul to Congress within six months and said the VA would consider “off-the-shelf” IT programs such as those developed by Microsoft to speed the process. The VA also wants to create a broader network of outside providers, predominantly federally run medical centres by the Pentagon and the Indian Health Service, plus academic teaching hospitals.

Currently, more than 30 per cent of VA appointments are made in the private-sector, up from fewer than 20 per cent in 2014, as the VA’s 1,700 health facilities struggle to meet growing demands for medical care.

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Follow Hope Yen on Twitter at https://twitter.com/hopeyen1

Hope Yen, The Associated Press

by Canadian Press

VA secretary urges extension of troubled Choice program

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