TriWest takes over VA community care programs nationwide

WASHINGTON — Veterans Affairs officials announced Tuesday that TriWest Health Care Alliance will take over nationwide operations for the department’s main community care programs despite concerns raised last month about overpayments to the company.

For the last five years, operations for the department’s primary two outside care programs — Patient-Centered Community Care and Veterans Choice Program — had been operated by TriWest and Health Net Federal Services.

The new contract extends TriWest’s partnership and names them the sole provider until the two programs are replaced next year with a new overarching community care program mandated in the VA Mission Act, which President Donald Trump signed into law this summer.

VA officials praised the contract as ensuring that veterans will not see disruptions in their health care in the coming year.

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“Extending the time and reach of our partnership with TriWest will ensure veterans get the care they need while the department transitions to delivering care under the Mission Act next year,” VA Secretary Robert Wilkie said in a statement.

Last month, the VA inspector general found that over a one-year period, TriWest officials filed more than 111,000 duplicate claims for outside care services and made mistakes in nearly 300,000 others, resulting in department overpayments of more than $45 million dollars.

Similar errors by Health Net officials resulted in $56 million in overpayments, investigators said.

In response, VA officials implemented new payment controls and recovered about $40 million of that money. Additional reimbursements are being reviewed.

Veterans’ cases currently being handled by Health Net will be transitioned to the new program in a way department officials promise will not disrupt care. Details of how other cases will be transferred from existing community care programs to future ones have yet to be finalized.

On Friday, congressional staffers received a briefing from VA officials on the Mission Act implementation, laying out future timelines for new community care rules and parameters for that work.

Last week, in an appearance before the Senate Veterans Affairs Committee, VA Secretary Robert Wilkie predicted the new community care rules will “revolutionize veterans’ care” once implemented.

“My view of Congress' trust and mission is to … give that veteran choice and allow that veteran to continue with the choice that he or she is most comfortable with,” he said.

In Other News

TriWest takes over VA community care programs nationwide

The move comes as department officials work to overhaul VA's outside care programs over the next year.

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