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Lawmaker wants vets to be able to seek private care without pre-approval

Jun. 3, 2014 - 12:39PM   |  
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A congresswoman who served in Iraq wants the Veterans Affairs Department to let veterans seek medical care from private physicians without needing approval from the VA first.

Rep. Tulsi Gabbard, D-Hawaii, one of two female combat veterans in Congress, wrote a letter to President Obama on Monday urging him to use his executive powers to order VA to pay for private care for vets unable to get an appointment at a VA facility.

While VA already has the ability to approve outside or “non-VA care,” veterans must “undergo bureaucratic red tape” to get that authorization, leaving their “health and well-being in the hands of a broken system,” according to Gabbard.

“This is a crisis, and as such, private medical care must be available to veterans without VA pre-approval,” Gabbard wrote.

The Hawaii National Guard veteran’s proposal is the latest of lawmaker initiatives intended to accelerate veterans’ access to health treatment.

Several bills have been floated or are in the works, including one by Rep. Adam Kinzinger, R-Ill., that would direct VA to enter into contracts with private physicians to provide care, and another from House Veterans’ Affairs Committee Chairman Rep. Jeff Miller, R-Fla., that would allow any veteran who could not be seen by VA within 30 days the option to go to a private doctor and bill VA.

Senate Veterans’ Affairs Committee Chairman Sen. Bernie Sanders, I-Vt., will introduce legislation this week proposing that veterans who cannot get timely appointments be allowed to go to community health centers, military hospitals or private physicians.

On Tuesday, Republican Sens. John McCain and Jeff Flake of Arizona, Tom Coburn of Oklahoma and Richard Burr of North Carolina will introduce a bill that would allow veterans to seek care outside the VA system under certain conditions.

But Sanders’ bill also would broaden access within VA, authorizing the department to lease 27 new health facilities as well as hire new doctors, nurses and other providers.

VA officials on May 27 released details of the department efforts to speed veterans’ access to care. Under the initiative, VA began a departmentwide review of primary care clinics to determine staffing shortages, authorized extended hours and overtime for providers, and directed VA health facilities to increase use of non-VA care where the hospitals and clinics cannot meet demand.

The Veterans Health Administration serves 6.5 million veterans at more than 150 medical centers, 800 clinics and 300 vet centers. The system handles 230,000 appointments per day.

The VA has been under fire since April when a retired physician from the Phoenix VA sent letters to CNN and the Arizona Republic alleging that the facility’s off-the-books wait list may have led to the deaths of at least 40 patients.

An investigation from the VA inspector general found at least 1,700 veterans seeking care from VA at Phoenix had been left off the official electronic wait list and veterans waited an average of 115 days for their first primary care appointment.

A VA inspector general official said May 21, however, that his office had reviewed 17 of the deaths at Phoenix and did not find evidence that the delays in care contributed to patient deaths.

In 2010, a senior VA official sent a memo to VA regional directors warning them to stop “gaming” the scheduling system, such as changing dates, fudging numbers and backdating appointments to align with VA central office goals.

In her letter to Obama, Gabbard asked that the stopgap measure be in place for at least a year or more.

“To make any veteran wait for medical care is not only an emergency, it is a travesty,” Gabbard said.

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