VA Asks for Comment on Proposed Access Rules; DAV Gives a Thumbs Down

A doctor uses a stethoscope to listen to the heart of a Vietnam Veteran (Photo:
A doctor uses a stethoscope to listen to the heart of a Vietnam Veteran (Photo:

A top official from the Disabled American Veterans service organization warns that the Department of Veterans Affairs risks repeating the mistakes of the failed Choice program with its proposed new rules for access to private health care.

The proposed access standards for the Mission Act, to expand private health care options for veterans, were put forward arbitrarily and are "no different than what we had under the Choice program" in terms of improving care, said Randy Reese, executive director of the DAV's Washington headquarters.

"We have quite a chore ahead of us to understand the depth of those regulations and the actual impact" on veterans, he said Tuesday at a joint hearing of the House and Senate Veterans Affairs Committees on the DAV's legislative agenda.

"And, unfortunately, with the absence of market assessments, we're not sure that the care would actually be there if veterans are referred" to private care, Reese said in response to questions from Sen. Mazie Hirono, D-Hawaii.

"Even if [veterans] are referred" to a private doctor, there are no assurances "that it's going to be the quality care that we have expectations of our VA to deliver," he said.

At another joint hearing of the veterans committees Wednesday on the American Legion's agenda, Legion National Commander Brett Reistad said the VA "must live up to its mission of serving veterans, as opposed to serving private health care providers" under the Mission Act.

He said the Legion generally supports the VA's intention to change the access rules for private care "based on actual drive times as opposed to straight-line mileage" to a VA facility.

"The American Legion does not oppose choice" for veterans on whether to get their health care from the VA or the private sector, Reistad said, "but we adamantly oppose any plan that would gut the best health care system in our country."

The VA's proposed new access standards were published in the Federal Register last week. The period for public comment continues until March 25.

In a statement on the release of the new standards, VA Secretary Robert Wilkie said, "Most Americans can already choose the health care providers that they trust, and President Trump promised that veterans would be able to do the same."

He added, "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 Choice program, officially the Veterans Choice, Accountability and Transparency Act of 2014, was enacted in response to wait-times scandals and doctored records at the Phoenix, Arizona, VA Medical Center.

Under Choice, veterans could have access to private care if they lived 40 miles from the closest VA medical facility or if they had been waiting 30 days or longer for VA care.

With the proposed rules, the wait-times standards would be 20 days for primary and mental health care, and 28 days for specialty care from the date of request.

The new rules would also be based on drive times rather than mileage. Veterans would be eligible for private care if they faced a 30-minute drive to the nearest VA facility. The drive times go up to 60 minutes, and the wait times to 28 days, for certain types of specialty care.

At the joint hearing Tuesday, Sen. Jon Tester, D-Montana, ranking member of the Senate Veterans Affairs Committee, said the VA has yet to spell out how the Mission Act will be implemented or how the new access standards will impact quality care.

"There is a very real concern that we cannot hold community providers to the same standards as the VA providers," Tester said, and "nobody can tell us how many veterans will be impacted by these access standards or how much it will cost."

At the joint hearing Wednesday, Sen. Johnny Isakson, R-Georgia, chairman of the Senate committee, said implementation of the Mission Act and access standards will be a main focus this year.

"We'll make mistakes" along the way, but "we're not going to make the mistake of privatizing" the VA's health care system, he said.

At a separate hearing Tuesday, Rep. Debbie Wasserman Schultz, D-Florida, chair of the Military Construction, Veterans Affairs, and Related Agencies Appropriations Subcommittee, also raised concerns about the implementation and funding of the Mission Act.

"I absolutely do not want to see community care funded at the expense of traditional VA medical services," she said.

"I am very concerned that the recent access standards announced by VA will ultimately send more veterans into the community," Wasserman Schultz said. "If there is not an intentional effort to privatize the VA, it sure seems like an effort to back it into it so that is the result."

Ahead of the release of the new access standards, Wilkie predicted that their publication would result in charges of privatization.

"Although these new standards represent an important win for America's veterans, they will not be without controversy," he said in a January statement. "Some will claim falsely and predictably that they represent a first step toward privatizing the department."

-- Richard Sisk can be reached

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