The former chairwoman of the Senate Veterans' Affairs Committee wants to overhaul the VA Choice program — the initiative that lets veterans see private physicians if they can't get an appointment at a VA medical center.

Sen. Patty Murray, D-Wash., said veterans in her state continue to wait weeks or months for needed medical care, unable to make timely appointments at the VA or through the Choice program.

Speaking on the Senate floor Thursday, Murray proposed an overhaul to Choice that would include strict guidance and clear eligibility rules designed to help veterans fully understand the program.

She said a revision also should streamline the process for doctors and medical personnel and the system itself, which suffers from duplication of contracts to provide non-VA care as well as mismanagement.

"I hear frequently from veterans ... about how difficult the Choice program has been," Murray said. "I hear how frustrating some of the bizarre rules and restrictions are — for example, an authorization for care only lasts 60 days. If you're a woman veteran and you're pregnant, you're going to need more than 60 days of care."

A Murray aide said many other lawmakers are hearing similar complaints from veterans who are having trouble accessing medical care through Choice. The aide described Murray's announcement as an "opening salvo" for Congress to improve the program.

"Senator Murray voted for the program and she believes in the intention of it," the aide said. "But implementation has been difficult. It's not working as well as it should for the veteran."

Murray's proposal comes a month after VA released the findings of an independent assessment of the VA health system that concluded it is plagued by bureaucracy and leadership challenges and fails to provide uniform services to veterans across the country.

The assessment said that without a complete overhaul, the VA's health care problems will continue, with the department "following an unsustainable trajectory of capital costs" and veterans failing to receive proper care.

The $10 billion VA Choice program was launched earlier this year to help ease medical appointment wait times and improve access to care for veterans who don't live near a VA medical center.

From January through June, the VA authorized 115,645 appointments for veterans, and 84,385 appointments were made.

But the rollout has had its challenges: Veterans who live within a 40-mile radius of a clinic often still must travel long distances to reach a VA facility that provides specialty care.

Veterans in rural, sparsely populated areas also face challenges finding doctors who know the program. VA Choice also often overlaps with legacy programs that provide non-VA care, creating administrative confusion.

"The system is so complicated, it's impossible to just get good health care," Murray said. "It is time for VA to implement one non-VA care program for the future."

Some lawmakers have cited extensive wait times and ongoing issues with medical care as reasons the Veterans Health Administration needs a complete overhaul.

VA Secretary Bob McDonald has said radical transformation already is underway, in the form of MyVA, an effort to improve customer service and systems by trimming excess layers of bureaucracy from duplicative hotlines and single-subject offices.

Murray said that without further improvement, especially to Choice, she would not be surprised if the VA continues to have problems serving veterans.

"I stand ready to work with anyone to do this and hope my colleagues will join me from both sides of the aisle ... I [also] hope the administration is ready to fundamentally reshape this program," Murray said.

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

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