Veterans who must drive more than 30 minutes to reach their Department of Veterans Affairs mental health or primary care providers would be allowed to use a private doctor for their health care under newly proposed rules the VA.
For specialty care, Veterans could go outside the VA for medical treatment if a VA provider was longer than a 60-minute drive away.
The draft rules are part of the VA Mission Act – a law scheduled to take effect this summer that aims to extend Veterans’ access to private-sector doctors. VA Secretary Robert Wilkie said earlier this week that the new access standards would “revolutionize” the VA health care system. “Most Americans can already choose the health care providers that they trust, and
President Donald Trump promised that Veterans would be able to do the same,” Wilkie said in a statement. “With VA’s new access standards, the future of the VA health care system will lie in the hands of Veterans – exactly where it should be.”
The Mission Act will replace the Veterans Choice Program, which was created in response to the 2014 VA wait-time scandal. Under that program, VA patients are allowed to go outside the system when they live more than 40 miles driving distance from a VA facility or it is estimated their wait for a VA appointment is longer than 30 days. There was widespread consensus among Veterans and lawmakers that the rules of the Choice program were too rigid. Congress passed the Mission Act with bipartisan support last year, giving the VA secretary broad authority to create new rules governing the private-sector care program.
In addition to the new drive-time standards, the VA is proposing that any veteran who must wait more than 20 days for primary or mental health care be allowed into private-sector care. For specialty care, the agency proposes a 28-day wait. VA Press Secretary Curt Cashour confirmed statistics from the New York Times, which reported the proposed rules would increase eligibility for community care from 8 percent of VA patients now to somewhere between 20 and 30 percent.
The agency believes not all Veterans who are eligible for outside care will opt for it, he said. “Eligibility for community care is not the same as actually opting for community care,” Cashour wrote in an email. “Veterans like the care VA offers.” The VA plans to post the proposed rules to the Federal Register, where members of the public will be allowed to provide input. Under the law, the rules must be finalized by the beginning of March. There have been numerous criticisms from Democratic and Republican lawmakers, as well as major Veterans organizations, who believe the VA should have worked with them more closely to establish the rules.
Many Veterans organizations that supported the Mission Act have opposed plans to allow Veterans unfettered access to the private sector – a move they worry could strip resources from the VA health care system. The VA insisted they had enough money to handle the cost increase for the remainder of the fiscal year and the changes would not affect funding for VA medical centers. The VA’s annual budget request, typically released in February, will include additional money to cover the increase in fiscal year 2020, Cashour said. Concerned Veterans for America has pushed for an aggressive expansion of Veterans’ care into the private sector. In a statement, the group said it was mostly pleased with the rules, though they wanted the 20-day wait standard to be shorter. “These proposed access standards will ensure Veterans have better access to health care and will give them more choices in how they receive their care,” said CVA Executive Director Dan Caldwell.