More veterans will be able to use the Veterans Affairs Choice Card program as of Friday under a change that redefines the 40-mile distance standard established as a requirement for care.

In a final rule published in the Federal Register, VA made good on a promise it made in March to change the mileage requirement from a straight-line, "as the crow flies" measure to actual driving distance from a VA medical facility.

The change is effective immediately.

In the announcement, VA officials said the change will expand the program, which allows veterans to see a civilian health care provider if they live in a remote area or can't get an appointment at a VA facility, to more former service members.

"This update ... will allow more veterans to access care when and where they want it. We look forward to continued dialogue with veterans and our partners to help us ensure continued improvements for veterans' to access care," VA Secretary Bob McDonald said in a statement.

In the rule, VA defended its original interpretation of the 40-mile requirement, saying the authors of the VA Access, Choice and Accountability Act passed last year intended for the department to use the straight-line measure.

But that interpretation, which went into effect in November, quickly came under fire from lawmakers, veterans service organizations and vets who live closer to a VA medical facility than 40 miles but must drive long distances to get there because of winding roadway routes or geographic impediments such as mountains, rivers, lakes and, in some cases, oceans.

Comedian Jon Stewart on his "Daily Show" even ridiculed the interpretation on March 23.

" 'As the crow flies' ... because that is the least meaningful way to judge how hard it is to get somewhere for non-crows," Stewart joked.

However, the new interpretation fails to address the plight of veterans who live within 40 miles of a VA health facility but need care beyond the scope of that facility.

Some former service members, like Air Force veteran Mark Gendron, who requires psychiatric care for post-traumatic stress disorder, live within 40 miles of a VA clinic that provides basic health services. But the nearest VA psychiatrist to Gendron is 70 miles away in St. Cloud, Minnesota.

And he doesn't qualify to see a specialist closer to home because of his proximity to that VA clinic.

"I just want to get the care I need," Gendron said. "I shouldn't have to deal with this."

VA officials told Congress in March that new legislation will be needed to expand the VA Choice program to veterans like Gendron.

"We believe we need statutory authority and your help on this issue," VA Deputy Secretary Sloan Gibson said.

House members on Thursday inserted a provision into the House version of the fiscal 2016 Military Construction and Veterans Affairs Appropriations bill that would require VA to factor driving time into determining eligibility for veterans to access care.

Noting that they have constituents who encounter traffic congestion or must use ferries or other modes of transportation to get to a VA medical center, 50 representatives drafted a letter to McDonald urging him to consider the time burden on veterans.

The VA funding bill with the time provision has been approved by the House Appropriations Committee but must now go to the full House for a vote and then be reconciled with the Senate before becoming law.

VA has a process to get patients to private care if they face undue burdens accessing VA care, but only 125 have asked for such waivers so far, According to Gibson.

As of March, about 45,000 medical appointments had been scheduled through VA Choice since November, officials said, adding that VA has distributed 8.5 million Choice Cards.

The new rule also will apply to beneficiary travel, according to VA.

To determine driving miles for eligibility, VA will use a commercial product it already relies on for its beneficiary travel program.

Officials said the distance now will be calculated using the fastest route rather than the shortest route.

In coming weeks, all veterans now eligible for Choice under the revised calculation will receive letters from VA notifying them of the change.

Staff writer Leo Shane III contributed to this report.

Patricia Kime is a senior writer covering military and veterans health care, medicine and personnel issues.

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