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Vets are already eligible for private care, GAO says

Jun. 18, 2014 - 01:36PM   |  
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WASHINGTON — Veterans facing long wait times, long distances or lack of specialty care are already eligible for medical care outside Veterans Affairs, calling into question the need for a law that allows private care, the Government Accountability Office said Wednesday.

However, there's no way to determine whether veterans will receive timely care through private facilities because VA does not collect that data.

"VA is authorized to obtain health care services from non-VA providers to help ensure that veterans are provided timely and accessible care," said Randall Williamson, director of health care at GAO, at a House Veterans Affairs Committee hearing. "It is not only important to ensure that veterans will obtain timely treatment from non-VA providers but also to ensure that non-VA medical care is a reliable and cost-effective means for VA to deliver services."

Both the House and Senate passed bills that would allow veterans access to private care if they faced long waits, but the bills also provide some extras, such as money to hire providers and the ability to fire inefficient VA employees.

Williamson said VA has announced its intent, in response to scandals about thousands of veterans dying while waiting for a first appointment, to allow more veterans to use non-VA providers.

But VA is unable to determine how sending veterans to private care could cut down wait times and costs because it does not collect data on wait times data or on all health services provided, he said.

A 2013 report found VA does not collect data to determine that information, and a 2014 report found "non-compliance" at four VA facilities because they did not provide emergency care to veterans, as required by law, even if the care was not for service-connected issues. About 20(PERCENT) of claims were denied inappropriately, GAO found. Veterans also do not know they are eligible for that care.

GAO made numerous recommendations to fix the problems, and VA agreed to the recommendations, but they have yet to be implemented, Williamson said.

Philip Matkovsky, assistant deputy under secretary for health for administrative operations at the Veterans Health Administration at VA, apologized again for the scandal Wednesday. He agreed that VA is already authorized to send veterans to private care, adding that VA is working to improve management, oversight and delivery of non-VA care.

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